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Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Published on: October 29, 2021

Patient-reported significant disability after major traumatic upper extremity amputation.

Joonas Pyörny¹, Margit Karelson², Ida Neergård Sletten³

¹Faculty of Medicine and Health Technology, Tampere University, Finland.

The Journal of Hand Surgery, European Volume

|November 23, 2023

Summary

Proximal upper extremity amputations significantly impact daily life and work, even after successful replantation or revision surgery. Many patients experience persistent disability and struggle to return to their previous employment.

Keywords:

Amputation replantation traumatic upper extremity

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Area of Science:

Orthopedic Surgery
Rehabilitation Medicine
Traumatology

Background:

Traumatic proximal upper extremity amputations present complex treatment challenges.
Replantation and revision amputation are surgical options, but long-term outcomes require evaluation.

Purpose of the Study:

To assess patient-reported outcomes following treatment for proximal upper extremity amputations.
To investigate return-to-work rates after these injuries and surgical interventions.

Main Methods:

A cohort of 38 patients with traumatic amputations at or proximal to the carpus were identified.
31 patients participated, undergoing either replantation or revision amputation.
The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure was the primary outcome assessment.

Main Results:

Patients reported significant disability post-replantation (median DASH 30) and revision amputation (median DASH 33).
Cold intolerance, low hand function, and poor aesthetics were common complaints.
Out of 17 employed patients, 10 did not return to their previous work.

Conclusions:

Major upper extremity amputations lead to substantial functional limitations and reduced quality of life.
Even successful replantation does not guarantee a full return to pre-injury work capacity.
Patient-reported outcomes highlight the need for comprehensive rehabilitation and vocational support.