[The Krukenberg plasty and the provision of additional prostheses and technical aids]

In case of bilateral forearm stumps or anomalies the Krukenberg plasty is indicated on at least one side. It aims at creating a tactile grasping organ. The coordination of Krukenberg on one side and a myoelektric prosthesis an the other side is an optimal solution for the person without hands. A blind person without hands may not miss the Krukenberg arm. The operation technique and the different modifications are discussed together with the anatomic and physiological principles, and especially the technique modified by E. Marquardt is described in detail. Due to this technique the grasping surface and the ends of the branches can be covered with skin of tactile sensation preserving all forearm muscles. By this technique two branches are created which are strong and well supplied with blood and which have tactile and well padded grasping surfaces. The post-operative physical and occupational treatment including self-help training are an important part of treatment and aim at providing the newly created grasping organ with the capability and skill that are always required for all tasks in daily life. For functional and cosmetic reasons we provide the Krukenberg arm with an electromechanical prosthesis; the advantages of this treatment compared with other possibilities are discussed.