Novel Utilization of a Preangulated, Osseointegrated Implant in a Case of Metacarpophalangeal Amputation: Design, Technique, and Rehabilitation Protocols Plus Functional Outcomes.

Thumb amputations considerably impair hand function, yet many patients are ineligible for reimplantation. Osseointegration can greatly restore dexterity and sensation. This case presents the first reported thumb osseointegration operation in the U.S. and the first reported use of a preangulated thumb implant worldwide. A single-stage osseointegration procedure was performed without complication. Ten-week resonance frequency analysis demonstrated an Implant Stability Quotient of 61; no loosening occurred by 13 months. The patient demonstrated successful thumb-small finger opposition and reported considerable improvement in activities of daily living by 6 months. No implant complications or skin issues were observed. The patient's Action Research Arm Test score increased by 28 points within 13 months, whereas her Quick Disabilities of the Arm, Shoulder and Hand score decreased by 9% over this period. She also demonstrated sensation to heat/cold through her thumb implant. This case demonstrates the feasibility and safety of single-stage thumb osseointegration using a preangulated implant head. Patient-reported satisfaction and clinical function improved markedly. A single-stage approach offers potential advantages in recovery time over traditional 2-stage protocols. This fascinating case establishes an explicit framework for single-stage osseointegration in digital reconstruction, including single-stage technique, implant selection, prosthetic design, and rehabilitation procedures. It also highlights the potential for this technology to improve outcomes for thumb amputees ineligible for replantation.