Survey on the state of knowledge of upper limb bionic prosthetic options in German hospitals – a multicenter and multi-discipline inquiry

Abstract

Purpose: The development of upper extremity prosthetic replacement has progressed rapidly. These technological advances in bionics provide a reason to reconsider extensive upper limb reconstructive surgery. The purpose was to determine the level of knowledge and awareness among clinicians about important advances in bionic limb replacement. Methods: A multicenter and multi-discipline cross-sectional inquiry was designed to survey clinicians at German university hospitals regarding their knowledge of modern bionic prosthesis. Anonymous questionnaires were collected by email, telephone interview, and from submission within the hospital. The questionnaire was divided into 10 parts consisting of 40 questions. Seven parts queried factual knowledge and three parts queried self-perception of knowledge and awareness of surgical reconstruction for severe hand injuries and outcome of plexus brachialis lesions. Anonymous surveys were circulated to a representative sample of institutional specialists, residents and students in departments for plastic/hand surgery, plastic surgery only, orthopedics and trauma/hand surgery.Results: 105 questionnaires were returned by 30 specialists, 35 residents and 40 students. Specialists in plastic and reconstructive surgery departments with an additional hand surgery focus attained the highest accurate response rate (mean value=67% ± SD 13%). Specialists in other departments as well as residents and students attained lower scores. Additionally, the perception of the outcome of severe hand injuries and plexus brachialis lesions seems not to be satisfying and suggests a need to improve outcomes. Most survey responses indicated an insufficient ability to consult and supervise on patients for supply with bionic prosthesis.Conclusion: Survey findings indicate room for improving the state of knowledge and awareness regarding modern bionic prosthesis, especially among residents and students. In general, there is a perception of insufficient information regarding bionic prosthetic supply after severe hand injuries and unsuccessful reconstruction of plexus brachialis lesions. Modern bionic replacement options could significantly lower financial and social burdens of hand trauma compared to traditional surgeries. The lack of knowledge regarding this option may prevent or slow its implementation at hospitals. It is important to integrate bionic prosthetic supply at specialized centers after exact definition of surgical indication.

Keywords

• bionic prosthesis
• complex hand trauma
• amputation
• plastic surgery
• reconstruction upper limb