Patient-reported experiences with silicon-based prosthetic solutions and surgical options following thumb amputation

Abstract Thumb amputation substantially affects daily function, body image, and occupational abilities. Prosthetic solutions are often provided as a non-surgical option to restore hand appearance and support functional tasks. This study investigates factors influencing silicon-based prosthesis acceptance following thumb amputation, with a focus on functional limitations, pain, psychological adaptation, and social aspects. A mixed-methods approach was utilized, involving 28 patients with thumb amputation. Quantitative assessments (Brief Michigan Hand Questionnaire and Numeric Rating Scale) measured self-reported function and pain, while qualitative semi-structured interviews explored experiences and psychosocial factors affecting prosthesis acceptance and openness to secondary surgical reconstructions such as osseointegration. Most patients (80%) managed daily activities without using a prosthesis, finding aesthetic benefits more important than functional ones. Patients with distal amputations demonstrated higher prosthesis acceptance compared to those with proximal amputations. Half of the cohort could not return to prior manual work. Psychological resilience and body image adaptation supported facilitated coping, while persistent pain and dissatisfaction with prior surgeries reduced openness to further reconstructive options. Findings reveal a contrast between the literature’s emphasis on the thumb’s functional indispensability and patient-reported experiences. While most patients adapted to daily life without silicone-based prostheses, occupational demands remained a major challenge. Prosthesis acceptance in this cohort was primarily driven by aesthetic rather than functional considerations.