Prosthetic Hand

What is a prosthetic hand?

A prosthetic hand, or hand prosthesis, is an artificial replacement for an absent or sub-functional hand or part of your hand. A prosthetic hand can be as simple as a hook or as high-tech as a bionic hand.

A certified prosthetist can help you select the best hand prosthesis for your needs and lifestyle. They’ll also help you get the right fit, train you to use it and make adjustments as your needs change over time.

Who are prosthetic hands for?

You might be interested in a hand prosthesis if you've had or plan to have a partial or whole hand amputation. Different types of prostheses are available for different types of amputations, including:

• Partial finger/thumb.
• Partial hand (metacarpal/transmetacarpal).
• Whole hand (wrist disarticulation).
• Hand and partial lower arm (transradial).

Children born with congenital hand differences or absences may also benefit from a hand prosthesis. Children who start early with a prosthetic device can grow and develop with it, including those with:

• Symbrachydactyly (partial or total absence).
• Ectrodactyly (cleft hand).
• Radial dysplasia (club hand).

What are the different types of prosthetic hand devices?

Different types of prosthetic hand devices compensate for different hand differences and disabilities. There are a variety of partial finger, whole finger, partial hand and whole hand designs available.

Different types of hand prostheses also operate differently and offer different levels of functionality. Some types offer a more lifelike appearance, while others look and function more practically.

Passive hand prosthesis

Passive prostheses fit onto your existing limb and fill in the parts you don’t have. They’re called “passive” because they don’t function independently. But you can use them as a stabilizer or a carrying surface.

Passive prostheses, because they aren’t high-tech, can have a highly realistic appearance. A silicone restoration is a mostly cosmetic prosthesis that’s custom painted to look just like your natural hand.

As the most basic type of hand prosthesis, a passive prosthesis is likely to be the first type you’ll learn to adjust to living with. It’s also what healthcare providers usually recommend for a baby’s first prosthesis.

As you become more adept with hand prostheses, you might want to move on to a more functional type. But you might also want to keep a passive prosthesis for certain purposes, like social occasions.

Body-powered hand prosthesis

A body-powered hand prosthesis is a mechanical device that operates using a type of pulley system. You use the muscles in your residual limb to pull on a cable attached to the device to make it open or close.

If you have a body-powered whole prosthetic hand, you use your upper arm, shoulder and/or chest muscles to operate it. Body-powered fingers or fingertips attach to a band on your knuckle or wrist.

Most body-powered hand prostheses are rugged designs made for accomplishing practical tasks. They don’t take a lot of calibrating, and as they’re not electronic, it’s OK to get them wet and dirty.

A body-powered hook hand with adjustable grasping force is a popular choice for doing manual labor. There are also body-powered hand prostheses that look more natural, but they’re not as versatile.

Activity-specific hand prosthesis

While most prosthetic hands are designed to help you accomplish the miscellaneous tasks of daily living, some special tasks require a specialized tool. That’s what activity-specific prosthetic hands are for.

If you need a prosthesis to allow you to do your job, sport or hobby, you can get one specifically designed for that activity. A prosthetist will work with you to design a prosthesis that does what you need it to.

Activity-specific prosthetic hands can allow you to operate machinery, play an instrument or work out. They can help adults return to their former occupations and pastimes, and help children discover theirs.

This type of hand prosthesis is likely to be an alternate in your collection. You might use it at work and use a different one at home or vice versa. You might even have different ones for different activities.

Myoelectric hand prosthesis

A myoelectric prosthesis is an electronic device that responds to electrical impulses generated by your muscles. (“Myo” means muscle.) You learn how to squeeze your muscles to activate different functions.

Electrodes on your skin read your muscle contractions and signal to the device to make it open or close. This uses less force than a body-powered prosthesis, so it’s less stressful on your muscles over time.

You can get articulating myoelectric fingers or a whole myoelectric hand. A single-motor prosthetic hand can only open and close. But multi-articulating prosthetic hands have articulating fingers and thumbs.

These bionic hands have a futuristic, robotic look. Some come with a lifelike, removable silicone skin. You can program them to hold different positions and to open and close in different grip patterns.

What are the steps involved in getting a hand prosthesis?

Acquiring your own hand prosthesis and learning to use it is a big project. It will take time, patience and practice on your part, and you can expect to get to know your healthcare team really well in the process.

Here’s a brief breakdown of the steps involved:

1. Consultation and assessment. The process begins with a consultation and assessment with your healthcare provider. You’ll discuss your lifestyle, needs and goals to determine what type of prosthetic might work best. They’ll also assess whether your limb is physically fit to use one.
2. Fitting. When you’re ready, you’ll see your prosthetist for a fitting. They’ll take careful measurements, a cast or a 3D scan of your limb and your opposite hand, if you have one. They’ll also determine which muscle groups you’ll need to use to operate the prosthesis.
3. Basic training. When your prosthesis is ready, your prosthetist will show you the basics of how it works and how to take care of it. You’ll learn how to put it on and take it off, how to operate the mechanical parts, and how to charge the electrical parts if you have any.
4. Physical and occupational training. Next, you’ll work with a physical therapist and/or occupational therapist to learn how to use your prosthesis for your specific activities. You’ll practice exercises to strengthen the necessary muscles and drill different movement patterns.
5. Mental healthcare. While you’re working hard to rehabilitate your body physically, you’re also processing through a major psychological event. Your healthcare team should also include mental health professionals who can help support this part of your rehabilitation.

What are the advantages and disadvantages of using a prosthetic hand?

Not everyone with an absent or sub-functional hand chooses to use a hand prosthesis. Some people learn to adapt in other ways — for instance, by using other body parts, like teeth or feet.

Some people might not feel the benefit they would receive from using a prosthesis outweighs the cost and effort involved — especially if their job or lifestyle doesn’t really rely on having two hands.

However, even if you aren’t overly concerned with the practical benefits of a prosthesis, there are health benefits to consider. Your healthcare provider might recommend it for these reasons.

Using a hand prosthesis helps your remaining limb — and the rest of your body — work more closely to the way it would with two functioning hands. This distributes stress more evenly among your muscles.

Not using a hand prosthesis can cause you to overuse your opposite side, leading to risks like:

• Repetitive strain injuries on your opposite side.
• Reduced function or range of motion on your different side.
• Unbalanced posture and body alignment.
• Chronic neck pain and/or back pain.

Potential risks and side effects of using a hand prosthesis include:

• Pressure sores or chafing due to an improper fit.
• Sweat buildup inside the prosthesis, which requires cleaning.
• Muscle strains from overusing body-powered prosthetics.
• Mechanical breakdowns and electronic charging issues.

These risks are mostly avoidable with proper fitting, training and maintenance.

How long does it take to adapt to a prosthetic hand?

Many variables can affect how long it takes to adapt to your hand prosthesis, including the type you have, what you want to use it for, the way you practice and any complications you might be having.

Your healthcare team will work closely with you to design a customized exercise routine and a consistent schedule for practicing skills. This part of your rehabilitation can take up to a year.

Learning to use your body and your prosthesis cooperatively to complete a task takes time. Learning to program a bionic hand and toggle between the different movement patterns can take even longer.

While you’re learning to use your prosthetic hand physically, you’ll also be adapting to it mentally and emotionally. This process has its own timeline. Remember to practice patience and self-compassion.

What happens after rehabilitation?

When you and your healthcare team feel you’ve successfully adapted to your new prosthesis, you may not need to continue with regular physical therapy. Some people do, though, just like physical training.

In any case, your relationship with your prosthetist is likely to be a long-term one. You’ll need repairs and adjustments to your prosthesis over the years, as your physical and practical needs may change.

All prosthetics have an expiration date, so you’ll need to repeat the fitting process at that time. Technology also continues to evolve, and you may decide to upgrade your prosthesis before then.

As always, be sure to call on your healthcare team if discomfort or complications develop related to your prosthesis. They’ll advise you on treating and preventing issues like muscle strain and skin irritation.

Can you feel things with a prosthetic hand?

Researchers are working on developing ways to mimic sensation in a bionic hand. Several experimental models are in development, but sensation in a prosthesis isn’t an anticipated feature in the near future.

Can prosthetic hands move fingers?

A multi-articulating bionic hand has a tiny motor in each finger, which allows the fingers to move in different ways. They don’t move spontaneously, though. You must program the movements in advance.

Can you drive a car with a prosthetic hand?

A bionic hand with a variety of grip patterns can drive a car with an automatic transition. But you might want to install some modifications, too, like a steering wheel spinner or push-button controls.