Prosthetic replacements for the thumb.

Optimal management of thumb loss necessitates individual consideration of all options, including prosthetic fitting, in relation to the needs and circumstances of each patient. Increased availability and substantial technical improvements in hand prostheses are resulting in their more frequent utilization, alone or in conjunction with surgical reconstruction. It has been found, contrary to general recommendations, that digital prostheses do in fact follow the basic rule of upper limb prostheses: the more distal the amputation, the more benefit a prosthetic fitting will be as there is a corresponding increase in automatic control. The benefit of digital prosthetic fitting is most striking in activities such as playing the piano or typing. The success of prosthetic fitting depends greatly on the defining of realistic goals and on the prosthesis being developed to very high standards with efficient follow-up service arrangements.