Upper Extremity Amputees
I am a below knee amputee but I have worked with hundreds of upper extremity amputees in my career. In the past, my private practice has consisted of almost 15% upper extremity amputees, mostly below elbow but also above elbow and shoulder disarticulation.Statistically, only 30% of upper extremity amputees utilize prostheses. This is because if there is a sound arm then the amputee generally uses it for their activities of daily living. Also the most functional of terminal devices (hands, hooks) is the hook. Not the most visually pleasing device to wear in public.
There are some amazing devices using electric power and myo-control. Nonetheless, they still can only open and close the thumb and two fingers. The major advantage of electrically powered prostheses is their ability to function without all of the harness and strapping normally associated with upper limb prostheses. I am fully certified in upper extremity myoelectrics from Otto Bock and Motion Control and are familiar with their components.
Fit is still important in the upper extremity even though it is not necessary to walk on the prosthesis. Test sockets are essential to obtain the most contact with the body with the least amount of restriction. Many socket adaptations that are being touted as new are nothing more than a rework of older and tested designs. The main thing is to find a fit that works for the individual and that allows them the maximum range of motion with the greatest comfort.
There are also numerous terminal devices that are specifically made for various activities. Some examples are devices that allow bowling, fishing, hunting, and an array of specific interchangeable tools that can be attached directly to the arm.
