1937-3333 (c) 2015 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission. See http://www.ieee.org/publications_standards/publications/rights/index.html for more information. This article has been accepted for publication in a future issue of this journal, but has not been fully edited. Content may change prior to final publication. Citation information: DOI 10.1109/RBME.2016.2523799, IEEE Reviews in Biomedical Engineering Abstract— Partial hand amputation is perhaps the most frequent amputation level, worldwide. Although its annual incidence in western countries is roughly 1:18000 inhabitants, the treatments of partial hand amputations have modestly progressed so far. We have identified three main limitation factors to this progress: (i) the wide range of anatomical and functional presentations which makes difficult to find standardized and scalable solutions, (ii) the technological complexity in replacing the motor and sensory function of a lost digit in the size of a digit and (iii) the fact that a partial hand can be functionally successful mostly when it restores a lost opposition movement, i.e. the ability to oppose the thumb against the fingers while providing enough grasping force and aperture width. This paper presents an overview of the existing surgical and technological solutions for treating partial hand amputations, and is specifically targeted to (biomedical) engineers. We critically highlighted the advantages, limitations and open challenges. Remarkably, current fitting procedures rely on manual approaches by skilled prosthetic technicians rather than on modern engineering methods. Hence the objective of this work is to comprehensively but concisely overview the field in order to inspire engineers to develop new systems and procedures able to address current open issues. Index Terms— Myoelectric control, Upper limb prosthetics, Partial Hand Amputation, Prosthetic Management. I. INTRODUCTION partial hand amputation is a relatively common and devastating condition that may cause permanent disability, psychological distress, and loss of work to the individual, and poses a significant direct and indirect financial burden on patients and society [1]. By definition partial hand amputations include any amputation distal to or through the carpal bones without affecting wrist movements [2]. Four main levels can be identified based on the amputated digits (Fig. 1) [3]: 1. Transphalangeal, thumb spared (i.e. one or multiple Manuscript received August 14, 2015. This work was supported by the National Workers’ Compensation (INAIL) under the PPR3 grant. I. Imbinto, C. Peccia, M. Controzzi and C. Cipriani are with The BioRobotics Institute of Scuola Superiore Sant’Anna, Pontedera (PI), 56025 Italy (e-mail: ch.cipriani@sssup.it). A.G. Cutti, A. Davalli and R. Sacchetti are with the INAIL Prosthetic Centre, Budrio (BO), 40054, Italy. fingers); 2. Thenar, partial or complete (involves the thumb); 3. Transmetacarpal distal, thumb spared or involved (resection is across the palm); 4. Transmetacarpal proximal, thumb spared or involved (amputation near the wrist). These amputations can be associated to four main causes which are: (i) trauma: any kind of accident that causes the traumatic loss of a part of the hand, (ii) malignancy (i.e. tumors), (iii) disease such as vascular peripheral diseases (e.g. peripheral arterial occlusive disease, thromboangiitis obliterans), infections or nerve damages, and (iv) congenital anomaly: the malformation of the hand is present from birth (the prominent roots come from the use of specific drugs such as thalidomide and from genetic inheritance). Partial hand amputation is the most common type of amputation injury in the upper extremities. This is not surprising because digits are particularly vulnerable to injury, especially in the work setting, predominantly with machinery or in unskilled manual jobs [1], [4], [5]. Recent epidemiological studies revealed that from 68% to 78% of total trauma amputations involve the upper extremities and approximately 90% of these are partial hand amputations [6]. Fig. 1 Levels of partial hand amputation (adapted from [3]). The available information pertaining the annual incidence of partial hand amputations in the different countries is quite extensive: for example it ranges between ~1:20000 in Italy and Norway (TABLE 1) [7] to 1:18000 inhabitants in the United States [8]. We estimate larger figures in the developing countries or regions [9], [10], in areas where job conditions Treatment of the Partial Hand Amputation: An Engineering Perspective Ilario Imbinto, Carlo Peccia, Marco Controzzi, Andrea G. Cutti, Angelo Davalli, Rinaldo Sacchetti, and Christian Cipriani, Senior Member, IEEE Methodological Review A