Partial Hand Limb Differences: Through the Palm

Until recently, individuals with an amputation or congenital limb difference through the palm of the hand, or trans-metacarpal, had few options for a prosthetic device. Older generations of myoelectric devices had heavy battery packs and a lack of individually-powered fingers that made them impractical. Silicone restorations were the only passive option available as more functional passive digits, such as Point Digits by Point Designs, had not yet come to market. Fortunately, advances in prosthetic technology have yielded more and better options for people with a partial hand limb difference.

An amputation or limb difference through the palm refers to a residual limb with a functional wrist and a partial hand without fingers, but the thumb may remain.

When Candice Dicke’s parents first attempted to find a prosthesis for her congenital limb difference, the only options were made from hard plastic and were too uncomfortable to be functional. Candice adapted and learned how to bike, drive and weightlift, all without the use of a prosthesis. But as technology advanced, she wondered if basic two-handed activities like using a fork and knife, carrying groceries while opening a door, or preparing a meal could finally be easier. She consulted with our prosthetic team, and together, they decided her best option was a myoelectric prosthesis with multi-articulating fingers. One-on-one prosthetic training with our clinical therapy specialist helped Candice learn how to use her device at work and at home.

“Having a prosthesis makes my job a lot easier,” she said. While Candice’s prosthesis looks like a full hand, it’s actually a custom silicone socket with i-limb digits. Watch her use it in her video below:

Alex Krueger lost his fingers after catching them in an industrial paper shredder in the print shop where he worked. He was fit with i-limb digits, enabling him to return to work at the same company and improving his function in daily living activities like grocery shopping. While helpful for many day-to-day activities, the i-limb digits cannot get wet and aren’t ideal for Alex’s hobbies: fishing, shooting and bowhunting. That’s why his prosthetic team also fit him with a more rugged, activity-specific device that can handle getting wet or dirty. You can see Alex enjoying it in this video:

Patrick Clark’s bilateral limb difference made it difficult to do daily tasks like opening jars and using a fork. In response, Patrick’s prosthetic team recommended he be fit with Point Designs digits on one of his residual limbs. These are a passive prosthetic option which means he uses his opposite palm and thumb to to position the fingers open and closed. Each digit has a ratcheting mechanism and can lock into place to create a tight grasp around an object. Now Patrick can manage his daily routines, write with a pen and use his phone:

There are also passive silicone restoration options, like what Brendan Mandara uses. Now you see a limb difference ...

Now you don't!

As prosthetic technology advances, more options are becoming available for people with all levels of limb difference. If you or someone you care for has a through-the-palm limb difference, new prosthetic options are available, including silcione restorations, passive positional, myoelectric and activity-specific. Keep in mind that sometimes the most efficient devices for an individual may not resemble a typical hand at all! We would love to discuss all current options available during a complimentary consultation that we offer. Please contact us to schedule a date and time. Do you have an amputation at this level? We’d love to hear from you in the comments below. Thanks for reading!

For more information, see related Arm Dynamics articles here:

• Introduction to Myoelectric Prostheses
• Fishing with a Prosthesis
• An Introduction to Activity-Specific Prostheses
• Introduction to Passive Prostheses
• An Introduction to Custom Silicone Restorations