Long-Term Follow-Up Evaluation of Bilateral Total Hand Loss

Bilateral total hand loss is rare, and the challenges faced by the patient immediately
after the loss are quite different from the long-term responses to the physical loss of both
hands. This study evaluates the problems of these patients years after their injuries. The goal
is to evaluate long-term adaptation to the loss and the degree of successful coping achieved
by the patients.
Methods: Seven subjects in this descriptive study participated in an interview and physical
exam. They were asked about their physical, psychological, and social problems. Functional
Independence Measure (FIM) and Functional Assessment Measure (FAM) were used to assess
the levels of the major functional areas.
Results: All of the subjects considered their handicap a serious disfigurement but not an
impediment to finding a marriage partner or pursuing educational goals. All of the subjects,
however, were dependent economically although they wanted to be employed based on
their capabilities. Although 2 subjects used prostheses for activities of daily living, they all
needed assistance for self-care. Three of the subjects had diagnosed psychological problems
of anxiety and depression.
Conclusions: Bilateral total hand loss does not simply represent double the problems of
unilateral hand loss. The problems resulting from the loss of both hands are physical, social,
psychological, and economic and unique to these patients. The strength of the subjects came
from having good family relations, stable environments, and family emotional support to help
solve the numerous problems encountered on a daily basis. The subjects are able to maintain
stable personal lives because they experience respect and comprehension of their problems
by family members