[Prosthetic reconstruction of the upper extremity]

Area of Science:

• Biomedical Engineering
• Neurosurgery
• Rehabilitation Medicine

Background:

• Upper extremity prosthetics have advanced significantly in therapeutic value.
• Selective nerve transfers improve control of upper arm prostheses.
• Indications for prosthetic replacement are expanding.

Purpose of the Study:

• To provide an overview of surgical, therapeutic, and prosthetic options for upper extremity amputations or functional loss.
• To highlight advancements in prosthetic control and application.

Main Methods:

• A selective literature search was conducted.
• The authors included their own clinical experience.
• Medical records were reviewed.

Main Results:

• Selective nerve transfers to remaining stump muscles can generate up to six myosignals.
• These myosignals allow intuitive and simultaneous control of prosthetic joints.
• This facilitates efficient and harmonious prosthetic device control without level switching.

Conclusions:

• Prosthetic replacement, including elective amputation, offers a novel approach for functional reconstruction of the upper extremity.
• This is particularly beneficial for patients with non-functional hands due to severe soft tissue or nerve damage.