eMedicine Specialties > Physical Medicine and Rehabilitation > Prosthetics

Upper Limb Prosthetics: Multimedia

Author: Brian M Kelly, DO, Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School; Assistant Program Director, Residency Training Program, Consulting Staff, Service Chief 6A, Inpatient Rehabilitation Services, University of Michigan Health System
Coauthor(s): Percival H Pangilinan Jr, MD, Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Michigan Health System; Gianna M Rodriguez, MD, Instructor, Department of Physical Medicine and Rehabilitation, University of Michigan Health System; Robert C Mipro, Jr, MD, Assistant Professor, Program Director, Department of Medicine, Section of Physical Medicine and Rehabilitation, Louisiana State University Medical Center; Chief, Department of Physical Medicine and Rehabilitation, VAMC of New Orleans; Valerie S Bodeau, MD, Acting Assistant Professor, Consulting Staff, Medical Director of Outpatient Clinics, Department of Rehabilitation, University of Washington/Harborview Medical Center
Contributor Information and Disclosures

Updated: Jan 14, 2009

Multimedia

The various levels of an upper extremity amputati...
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Media file 1: The various levels of an upper extremity amputation.
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The various levels of an upper extremity amputati...

The various levels of an upper extremity amputation.

The patient with a transradial amputation de...
(Enlarge Image)
Media file 2: The patient with a transradial amputation demonstrates 2 types of harnessing: A. The figure-8 harness; B. The shoulder saddle with chest-strap suspension. The terminal device is activated by arm flexion or by biscapular abduction. C & D: For the patient with a transhumeral amputation, the same motions stated above move the elbow and operate the terminal device once the elbow is in locked position. To lock or unlock the elbow, the amputee must simultaneously use arm extension, shoulder depression, and arm abduction. Shoulder-saddle harnessing is used for heavier-lifting activities, or axillary pressure cannot be tolerated.
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The patient with a transradial amputation de...

The patient with a transradial amputation demonstrates 2 types of harnessing: A. The figure-8 harness; B. The shoulder saddle with chest-strap suspension. The terminal device is activated by arm flexion or by biscapular abduction. C & D: For the patient with a transhumeral amputation, the same motions stated above move the elbow and operate the terminal device once the elbow is in locked position. To lock or unlock the elbow, the amputee must simultaneously use arm extension, shoulder depression, and arm abduction. Shoulder-saddle harnessing is used for heavier-lifting activities, or axillary pressure cannot be tolerated.

More on Upper Limb Prosthetics

References
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References

  1. Biddiss EA, Chau TT. Multivariate prediction of upper limb prosthesis acceptance or rejection. Disabil Rehabil Assist Technol. Feb 10 2008;1-12. [Medline].

  2. Fryer CM, Stark GE, Michael JW. Body powered components. In: Smith DG, Michael JW, Bowker JH, ed. Atlas of Amputations and Limb Deficiencies. 3rd ed. Rosemont, Ill: Am Acad Orthop Surg; 2004:117-30.

  3. Fryer CM, Michael JW. Harnessing and controls for body-powered devices. In: Smith DG, Michael JW, Bowker JH, eds. Atlas of Amputations and Limb Deficiencies. 3rd ed. Rosemont, Ill: Am Acad Orthop Surg; 2004:131-44.

  4. Heckathorne CW. Components for electric-powered systems. In: Smith DG, Michael JW, Bowker JH, eds. Atlas of Amputations and Limb Deficiencies. 3rd ed. Rosemont, Ill: Am Acad Orthop Surg; 2004:145-72.

  5. Ashok Muzumdar, ed. Powered Upper Limb Prostheses. New York, NY: Springer; 2004.

  6. Esquenazi A, Leonard JA Jr, Meier RH 3rd, et al. Prosthetics, orthotics, and assistive devices. 3. Prosthetics. Arch Phys Med Rehabil. May 1989;70(5-S):S206-9. [Medline].

  7. Gitter A, Bosker G. Upper and lower extremity prosthetics. In: DeLisa JA, ed. Rehabilitation Medicine: Principles and Practice. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2005:1325-54.

  8. Lawrence M, Gross GP, Lang M, et al. Assessment of finger forces and wrist torques for functional grasp using new multichannel textile neuroprostheses. Artif Organs. Aug 2008;32(8):634-8. [Medline].

  9. Egermann M, Kasten P, Thomsen M. Myoelectric hand prostheses in very young children. Int Orthop. Jul 18 2008;[Medline].

  10. Van Dorsten B. Integrating psychological and medical care: practice recommendations for amputation. In: Meier RH, Atkins DJ. Functional Restoration of Adults and Children with Upper Extremity Amputation. New York, NY: Demos Med Pub; 2004:73-88.

  11. Malone JM, Leal JM, Underwood J, et al. Brachial plexus injury management through upper extremity amputation with immediate postoperative prostheses. Arch Phys Med Rehabil. Feb 1982;63(2):89-91. [Medline].

  12. Malone JM, Fleming LL, Roberson J. Immediate, early, and late postsurgical management of upper-limb amputation. J Rehabil Res Dev. May 1984;21(1):33-41. [Medline].

  13. Mayer A, Kudar K, Bretz K, et al. Body schema and body awareness of amputees. Prosthet Orthot Int. Sep 2008;32(3):363-82. [Medline].

  14. Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. Jul 2002;1(3):182-9. [Medline].

  15. Hunter JP, Katz J, Davis KD. Stability of phantom limb phenomena after upper limb amputation: a longitudinal study. Neuroscience. Oct 28 2008;156(4):939-49. [Medline].

  16. Meier RH, Atkins DJ. Functional Restoration of Adults and Children with Upper Extremity Amputation. New York, NY: Demos Med Pub; 2004.

  17. Glennon TP, Smith BS. Amputations. In: Garrison SJ, ed. Handbook of Physical Medicine and Rehabilitation Basics. Philadelphia, Pa: JB Lippincott; 1995:34-60.

  18. McIntyre KE Jr, Bailey SA, Malone JM, et al. Guillotine amputation in the treatment of nonsalvageable lower-extremity infections. Arch Surg. Apr 1984;119(4):450-3. [Medline].

  19. Spires MC, Miner L. Upper extremity amputation and prosthetic rehabilitation. In: Grabois M, ed. Physical Medicine and Rehabilitation: The Complete Approach. Malden, Mass: Blackwell Sci; 2000:549-82.

  20. Tan JC. Prostheses. In: Practical Manual of Physical Medicine and Rehabilitation. St Louis, Mo: Mosby; 1998:229-59.

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Further Reading

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Keywords

upper limb prosthetics, amputee, amputation, prosthetics, prosthetic, prosthesis, amputees, amputated, phantom pain, electric hand, artificial limbs, arm prosthetic, arm amputation, artificial limb, upper extremity prostheses, upper-extremity prosthesis, upper-limb prosthesis, upper limb amputation, upper extremity amputation, myoelectric prosthesis, body-powered prosthesis, above-elbow prosthesis, below-elbow prosthesis

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Contributor Information and Disclosures

Author

Brian M Kelly, DO, Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School; Assistant Program Director, Residency Training Program, Consulting Staff, Service Chief 6A, Inpatient Rehabilitation Services, University of Michigan Health System
Brian M Kelly, DO is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, and Association of Academic Physiatrists
Disclosure: Nothing to disclose.

Coauthor(s)

Percival H Pangilinan Jr, MD, Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Michigan Health System
Percival H Pangilinan Jr, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and Association of Academic Physiatrists
Disclosure: Nothing to disclose.

Gianna M Rodriguez, MD, Instructor, Department of Physical Medicine and Rehabilitation, University of Michigan Health System
Gianna M Rodriguez, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Paraplegia Society, American Spinal Injury Association, International Spinal Cord Society, and Philippine Medical Association
Disclosure: Nothing to disclose.

Robert C Mipro, Jr, MD, Assistant Professor, Program Director, Department of Medicine, Section of Physical Medicine and Rehabilitation, Louisiana State University Medical Center; Chief, Department of Physical Medicine and Rehabilitation, VAMC of New Orleans
Robert C Mipro, Jr, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and Association of Academic Physiatrists
Disclosure: Nothing to disclose.

Valerie S Bodeau, MD, Acting Assistant Professor, Consulting Staff, Medical Director of Outpatient Clinics, Department of Rehabilitation, University of Washington/Harborview Medical Center
Valerie S Bodeau, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Paraplegia Society, Association of Academic Physiatrists, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Elizabeth A Moberg-Wolff, MD, Associate Professor and Pediatric PM&R Fellowship Director, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin; Program Director, Tone Management and Mobility, Department of Physical Medicine and Rehabilitation, Children's Hospital of Wisconsin
Elizabeth A Moberg-Wolff, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine and American Academy of Physical Medicine and Rehabilitation
Disclosure: Medtronic Neurological Grant/research funds Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain (Tailbone Pain, Coccydynia) Service (www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Robert H Meier III, MD, Director, Amputee Services of America; Active Medical Staff, Presbyterian/St Luke's Hospital, Spalding Rehabilitation Hospital, Select Specialty Hospital; Consulting Staff, Kindred Hospital
Robert H Meier III, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and Association of Academic Physiatrists
Disclosure: Nothing to disclose.

 
 
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