title: Osseointegrated Finger Prostheses Using a Tripod Titanium Mini-Plate.
abstract: BACKGROUND
  Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients.
  
  
  METHODS
  A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded.
  
  
  RESULTS
  Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported.
  
  
  CONCLUSIONS
  When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Oscar J
authors.initials: OJ
authors.lastname: Manrique
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ciudad
authors.affiliation: Division of Plastic and Reconstructive Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Doscher
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Federico
authors.initials: F
authors.lastname: Lo Torto
authors.affiliation: Division of Plastic and Reconstructive Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Liebling
authors.affiliation: Departamento De Cirugía Plástica y Reconstructiva, Hospital Militar Central, Universidad Militar "Nueva Granada", Bogotá, Colombia.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Galan
keywords: Amputation; Osseointegration; Outcome assessment; Prostheses