In upper limb amputations we generally follow the same basic principles with those of the lower limbs, as far as the prosthetic and the surgical approach are concerned. In these cases, the surgeon and the prosthetic professional also have to face several challenges, during the treatment of a patient with an upper limb amputation.
Initially, the surgeon should assess the potential to save the limb, especially in cases of trauma or sepsis; the decision should be made immediately. When the amputation is determined, the height should be also determined. Several times, it is important to reserve the length of the upper extremities. However, it may be sacrificed for the sustainability of the abutment, the need to cover the bones and rarely for a better prosthetic result. The functional restrictions of the amputations and the prosthetic construction should be considered very carefully, especially for patients with upper limb amputations. Certainly, we should also consider the patient’s emotional and physical health .The following parameters constitute major targets of the upper limb surgical amputations:
- Maintenance of the functional length
- Solid coverage of bones
- Maintenance of the useful sensory receptors
- Prevention of symptomatic neuroma
- Minimization of short- and long-term illness
- Timely fitting of the prosthesis
- Early patient’s return to their daily routine
The target of the prosthetic professional is to sustain the limb’s functionality, having as a main concern to create an aesthetically accepted prosthesis. The possible solutions for the upper limb prosthesis are two (2).
- The Muscle electric - Functional prosthesis
- The Cosmetic Prosthesis
The basic target of the muscle electric prosthesis is to ensure functionality in movements and operations where the utilization of both limbs is needed. By adding a muscle electric limb, we ensure the partial functionality of the patient’s limb. Special electrodes receive the contractions of the remaining muscles in the certain part of the patient’s body, in order to achieve the independent activation of the mechanism (elbow, fingers or wrist mechanism). It is the only method which ensures the functionality of the prosthetic limb for the patient.
The cosmetic prosthesis is also known as a passive prosthesis because the artificial limb provides minimal ability of dynamic utilization. The cosmetic restoration attempts to construct a light prosthesis, easy to use, with minimal maintenance requirements.
The manufacturing process of a cosmetic prosthesis is achieved by using silicone materials, which, due to their complex composition, the multiple choices of color and the ease of molding, ensure the absolute similarity of the limb. We note that each case is treated as unique, for the best possible outcome.