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Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
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Optimal Sites for Upper Extremity Amputation: Comparison Between Surgeons and Prosthetists.

Brandon Apagüeño1, Sara E Munkwitz1, Nicholas V Mata1,2

  • 1University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Bioengineering (Basel, Switzerland)
|July 29, 2025
PubMed
Summary

Optimizing amputation levels for upper extremity amputations requires collaboration between surgeons and prosthetists. This ensures better prosthetic fit, function, and patient satisfaction, improving overall quality of life.

Keywords:
amputation levelfunctionprostheticupper extremity

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Area of Science:

  • Orthopedics
  • Rehabilitation Medicine
  • Prosthetics Engineering

Background:

  • Upper extremity amputations profoundly affect physical function, psychosocial health, and life quality.
  • Traditional surgical guidelines prioritize limb preservation, sometimes conflicting with prosthetic optimization needs.

Purpose of the Study:

  • To review discrepancies in optimal amputation levels between surgical and prosthetic recommendations.
  • To explore the impact of amputation level on prosthetic design, functionality, and patient outcomes.
  • To emphasize the need for a multidisciplinary approach in amputation planning.

Main Methods:

  • Literature review examining surgical and prosthetic perspectives on upper extremity amputation levels.
  • Analysis of prosthetic options (passive, body-powered, myoelectric, hybrid) and their suitability based on amputation site.
  • Discussion of emerging technologies like targeted muscle reinnervation (TMR).

Main Results:

  • Discrepancies exist between surgical and prosthetic ideal amputation sites, affecting prosthetic fit and function.
  • Residual limb length is crucial for mechanical efficiency, symmetry, comfort, and control.
  • Advanced technologies like TMR and myoelectric prostheses are enhancing rehabilitation.

Conclusions:

  • A collaborative, multidisciplinary approach involving surgeons, prosthetists, and patients is essential for optimal amputation planning.
  • Improved preoperative planning and interprofessional collaboration can enhance prosthetic outcomes and patient well-being.
  • Addressing the conflict between surgical preservation and prosthetic optimization is key to improving functional independence.