Thumb Reconstruction Using Osseointegrated Dental Implants for Prosthetic Retention Following Gunshot Amputation: A Case Report.

Thumb amputations severely compromise hand function, particularly grip and opposition. Osseointegration, originally developed for dental implantation, has become a promising method for directly anchoring prostheses to bone. This technique uses a two-stage protocol: first, a dental implant is placed into the medullary canal and allowed to integrate with the surrounding bone; once stable osseointegration is confirmed, a skin-penetrating abutment and custom prosthesis are attached. This approach provides secure fixation even when bone stock is limited and offers several advantages over conventional prosthetics, including improved retention, stronger grip and pinch function, increased range of motion, and enhanced osseoperceptive feedback. We present the case of a 38-year-old male who sustained a gunshot injury resulting in amputation at the base of the proximal phalanx of the right thumb. The first stage of reconstruction included metacarpophalangeal joint arthrodesis and first web-space widening using a four-flap Z-plasty. A dental implant was placed across the fusion site to provide both fixation for the arthrodesis and a stable anchoring platform for a custom prosthesis. This case suggests that osseointegrated dental implants may provide a feasible retention option for thumb prosthetic reconstruction, particularly when conventional reconstructive strategies are limited or contraindicated.