Hand Surgery and the Development of Hand Prostheses

Hand surgery has shown that afferent impulses to conscious level are essential for control and effective use of any advanced grip. Control of position, motion and load (proprioception) is possible to obtain without joint receptors, by cutaneous receptors alone. Further advances in the construction of hand prostheses must be based on this premise. The value of the key grip is outlined.     

Hand rejuvenation

Both skin and subcutaneous tissues are targeted in this multistage hand rejuvenation protocol. Topical therapies and intense pulsed light are used for skin thickening, rejuvenation, and improvement of age spots and leathery texture. Autologous fat is injected into multiple tissue layers to fill out underlying tissue. Excess skin is excised with a small, well-hidden incision on the ulnar surface.     

Hand transplantation

The surgical techniques necessary to perform hand transplantation have been available for at least 25 years. In this article, the authors provide a review of hand transplantation, including its history, preoperative evaluation, and case reports. Data on transplant preparation, operation data, immunosuppression, rejection, immunologic assessment, and functional assessment are presented in easy-to-use table format.