In America today, there are on average 185,00 upper limb amputations per year (Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation2008;89(3):422-9.). The number of total amputations performed in Texas each year increased 30.30% from 2007 to 2014 according to hospital discharge data. A total of 108,031 amputation procedures were performed in this time period. These numbers can seem overwhelming. Fortunately, in today’s healthcare market, there are many options for people who suffer from an upper limb amputation.
There are a few local prosthetics companies in the DFW area as we live in a large metroplex with a great medical community. In addition, the therapists at Ascend Hand Therapy have treated and are currently treating several patients with some level of upper limb amputation. In Texas, most upper limb amputations tend to be finger amputations. In 2014, 821 out of 1098 upper limb amputations were finger amputations. Initially following surgery, a patient with an amputation is seen by one of our therapists to address proper wound healing, range of motion, nerve hypersensitivity, and overall functional use of the affected limb. If a patient needs a prosthetic, then therapy focuses on training on use of the new prosthetic.
Prosthetics can be passive, body-powered, myoelectric, or a hybrid prothesis. A passive prothesis is primarily for aesthetics. If someone has a fingertip amputation, a passive prosthesis would attach to the residual stump and have the appearance of a normal fingertip. The prosthetist can make the prosthesis look just like the rest of the hand in terms of skin coloring, hair follicles, etc. A body-powered prosthesis uses one’s own body movements to cause the prosthesis to move.
This type of prothesis is a very functional option for manual laborers or for activities that require lots of force, such as lifting a heavy object with two limbs. A myoelectric prosthesis is battery powered and uses electrodes over specific muscle groups to allow the patient volitional control of the terminal device. Think Luke Skywalker. In fact, one company has a prosthesis named “LUKE” after the Jedi himself. And the final option is a hybrid prosthesis that combines both body-powered and myoelectric aspects of the device. For example, the elbow could be body-powered, whereas the hand could be myoelectric.
As you can see, there are many options today for people who have suffered some level of amputation. The ultimate goal of any prosthesis is to increase function. If the prosthesis does not help someone function more independently, then the reality is they will not use the device. Therapy is an important aspect of helping someone regain functional use of their upper extremity, even if that upper extremity belongs to someone like Luke Skywalker!
(prostheses pictures from http://www.pandocare.com/upper-extremity-types)