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Prosthetic usage in major upper extremity amputations

T W Wright1, A D Hagen, M B Wood

  • 1Department of Orthopaedics, Mayo Clinic, Rochester, MN, USA.

The Journal of Hand Surgery
|July 1, 1995
PubMed
Summary
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This study found that below-elbow amputation patients most successfully used modern upper extremity prostheses. However, overall prosthesis rejection was high, influenced by factors like stiff shoulders and brachial plexus injury.

Area of Science:

  • Orthopedics
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Major upper extremity amputations significantly impact patient function and quality of life.
  • Contemporary prosthetic technologies offer potential for restoring lost function.
  • Understanding prosthetic usage patterns is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the usage patterns of myoelectric and body-powered prostheses in patients with major upper extremity amputations.
  • To identify factors influencing prosthetic acceptance and rejection.
  • To determine the long-term effectiveness of prostheses across different amputation levels.

Main Methods:

  • A questionnaire-based study was conducted on 135 patients with major upper extremity amputations.

Related Experiment Videos

  • Patient data included amputation level, prosthesis type (myoelectric or body-powered), and usage patterns.
  • Follow-up intervals averaged 12 years, with a range of 1-67 years.

    • Main Results:

    • The overall prosthesis rejection rate was 38%.
    • Patients with below-elbow amputations showed the highest usage and benefit (39 of 42).
    • Bilateral amputees universally used their prostheses, while wrist disarticulation and above-elbow groups had lower usage rates.
    • Stiff shoulders and brachial plexus injury were identified as predictors of poor prosthetic usage.

    Conclusions:

    • Prosthetic success varies significantly with amputation level, with below-elbow amputations demonstrating the most favorable outcomes.
    • High rejection rates highlight the need for improved prosthetic design and patient selection criteria.
    • Factors such as pre-existing joint stiffness and nerve injury negatively affect prosthetic utilization and warrant further investigation.