Request pdf upper extremity amputation although significantly less common than vascular insufficiency in the lower extremities, heart, or brain, processes leading to inadequate vascular. A harness, worn around the opposite shoulder, much like a backpack strap, is connected to a cable, elbow if transhumeral or higher amputation level and terminal device. Upper extremity amputation is a surgery to remove all or part of the arms, hands, or fingers. Functional and clinical outcomes of upper extremity amputation. Disorders that are commonly related to amputation include trauma, cancer, infection, blood vessel disease and birth deformities or diseases. Major amputations of the upper extremity other than digital amputations account for 3% to 15% of all amputations and are approximately 20 times less common than amputations of the lower extremity. Upper extremity amputee exercises by mcop team september 4, 2019 living with your prosthetic, amputee support, amputee info upper extremity amputation exercises.
Upper extremity functional index msu rehabilitation. Management of major traumatic upper extremity amputations. The level of upperextremity amputation is the most important determinant of postamputation function. Trauma amputation upper extremity revision amputation management. Participants will be able to identify common causes for upper and lower extremity amputation and demonstrate an understanding of the medical complications that require management throughout both the pre and postprosthetic phases of rehabilitation. The upper extremity functional index uefi we are interested in knowing whether you are having any difficulty at all with the activities listed below because of your upper limb problem for which you are currently seeking attention. Initial management of the acute traumatic upper extremity amputation begins with the principles of. Therefore the guidelines for treatment, care and support for amputees within the lss living in the community are proposed to fill this gap in the literature and to guide the provision of treatment, equipment, prosthetics, home modifications and attendant care for upper limb, lower limb and multiple limb amputees. Updated 122014 by rick bowers passive prostheses are generally considered to be devices that are worn purely for cosmetic purposes.
Prosthetic usage in major upper extremity amputations. Upper extremity amputation orthopaedic trauma association ota. Amputations of the upper extremity musculoskeletal key. February 2011 a free powerpoint ppt presentation displayed as a flash slide show on id. First, the forequarter amputation involves the resection of the clavicle and all structures distally. Current concepts in upperextremity amputation orthocarolina. The thread of innovation is woven throughout our nearly 100year history. The causes of amputation vary from country to country. In the united states, overall, there are approximately 1.
Pdf replantation of upper extremity, hand and digits. Introduction major upper extremity amputees account for only 8% of the 1. Lower extremity amputation and prosthetic rehabilitation. One of the primary goals of surgery is to save as much of the limb as possible. Upper extremity amputations portnotes orthopaedicsone. Replantation of the upper extremity is a wellestablished method in the treatment of amputation injuries that has a substantial socioeconomic impact. On the farm, injuries resulting in an amputation are typically caused by entanglement, entrapment, crushing injuries, or infection from a traumatic injury. Modern amputation technique in the upper extremity. In the printed or pdf version of this article, author affiliations can be found at the bottom of the. Most amputations involve small body parts such as a finger, rather than an entire limb. The main causes for an upper body amputation would be accidents or sudden trauma. Purpose arms, legs, hands, feet, fingers, and toes can be amputated. Upper extremity orthopaedic trauma association ota.
Fingers or partial hand transcarpal at the wrist wrist disarticulation below the elbow transradial at the elbow elbow disarticulation above the elbow transhumeral at the shoulder shoulder disarticulation above the shoulder forequarter. Upper limb amputations nova scotia health authority. Immediate, early and late postsurgical management of upper limb amputation. Sep 04, 2019 upper extremity amputee exercises by mcop team september 4, 2019 living with your prosthetic, amputee support, amputee info upper extremity amputation exercises. Guidelines for treatment, care and support for amputees. Nevertheless, it is unrealistic to automatically write off such individuals as being totally disabled. Resources by amputation level to easily sort through the resources we offer, we have created categories to make it easier to find what you are looking for. Therefore the guidelines for treatment, care and support for amputees within the lss living in the community are proposed to fill this gap in the literature and to guide the provision of treatment, equipment, prosthetics, home modifications and attendant care. Rehabilitation of lower limb amputation describe evidencedbased prosthetic and amputation rehabilitation outcomes understand the importance of good working relationship between a physical therapist and prosthetist identify appropriate fit of lower extremity prostheses describe how the information gained during the. Oct 02, 2019 upper extremity amputations largely follow the same basic principles as those of any amputation. Three types of upper limb amputations occur in this area. The bilateral upper extremity amputation causes significantly greater vocational handicaps than the single upper extremity amputation. To easily sort through the resources we offer, we have created categories to make it easier to find what you are looking for.
The general principles of upper extremity amputation will be common to amputation at any level. Refresh your rehabilitation strategies for upper extremity. Review therapy clinical amputation, upper extremity, in. One of the most effective ways to recover from an upperextremity amputation is to find a challenging, yet realistic fitness routine to adhere to here, youll find some of the most easyto. Upper extremity amputation gennadiy busel, md joao panattoni, md. Pdf the importance of rehabilitation concerning upper extremity. An upper extremity amputation has a major impact on the individuals physical, social, vocational, and emotional life. The execution of a successful amputation at each level of the limb allows maximum use of the residual extremity, with or without a prosthesis, and minimizes the known complications of these injuries.
Unlike lowerlimb amputations, upperlimb amputations are most often the result of sudden trauma to the body, although they also can be caused by malignancy, congenital deficiencies, and vascular disease. Replantation of upper extremity, hand and digits article pdf available in acta chirurgica iugoslavica 602. Key words primary amputation, prosthetics, reinnervation, surgical reconstruction, upper extremity. It is performed to remove diseased tissue or relieve pain or due to trauma. The occupational therapy role in rehabilitation for the person with an upperlimb amputation. Prosthesis use in persons with lower and upperlimb amputation. Upper extremity amputation is an accepted treat ment option for acute trauma or sequelae of traumatic injuries, chronic infection, bone or soft tissue tumors, certain brachial plexus injuries, and complex regional pain syndrome. An upper limb amputation is the removal of any part of the forearm or arm. For individuals who have sustained upperextremity injury or amputation that limits function, game play through the use of customadapted game controllers can provide a multitude of psychological and functional benefits. Functional prostheses, on the other hand, are devices that enable an amputee to perform tasks. Ppt upper extremity amputation powerpoint presentation. One of the most effective ways to recover from an upper extremity amputation is to find a challenging, yet realistic fitness routine to adhere to. An upper limb prosthesis is often prescribed to regain functionality. Objectives participants will be able to identify common causes for upper and lower extremity amputation and demonstrate an understanding of the medical complications that require management throughout both the pre and post.
As of january 2007, there have been a total of 541 major limb amputations seen and of this population there have been 111 unilateral upper limb amputees, 6 bilateral upper limb amputees, and combined upper and lower extremity amputees. Upper limb amputations vary from the partial removal of a finger to the loss of the entire arm and part of the shoulder. Upper extremity bilateral amputations written by hugh j. In all amputations, the goal is to remove a distal segment of the extremity. Activities of daily living assessment is a rating guide that provides a comprehensive list of adls an unilateral amputee should be able to accomplish. For individuals who have sustained upper extremity injury or amputation that limits function, game play through the use of customadapted game controllers can provide a multitude of psychological and functional benefits. Amputation occurring in the upper arm from the elbow to the shoulder. Adult patients with major lower extremity amputation bilateral and unilateral including throughhip, transfemoral, throughknee, transtibial, throughankle, and partial foot. A successful amputation and reconstruction can decrease the extent of the loss. Congenital limb deficiencies account for a small proportion of the total number of reported limb amputations, with a reported incidence of 4. The management of upper extremity amputation rehabilitation uear 2014 the uear cpg is designed to address the key principles of rehabilitation and clinical care for patients with upper limb amputation. Refresh your rehabilitation strategies for upper extremity amputation march 14, 2019 gary clark, md, paradigm medical director jean kirk, phd, paradigm director of clinical services. Behera definition amputation is the intentional surgical removal of a limb or body part. Younger men are more at risk for amputations causes by trauma, such as machinery, motor vehicle or workrelated accidents.
Thiscan be done for each type of prosthesis the patient wears. This article highlights the special considerations involved in. Prothesis use in persons with lower and upper limb amputations. Upper extremity amputation 1 upper extremity amputation.
Farming with upper extremity limitationamputation ohioline. Validation of the orthotics and prosthetics user survey upper extremity functional status module in people with unilateral upper limb amputation. Upper extremity amputations can include finger amputations, hand amputations, and arm amputations either belowelbow or aboveelbow. The overall goal of amputation rehabilitation is to optimize the patients health status, function, independence, and quality of life. Rehabilitation for persons with upperextremity amputation. Trauma is the most common reason for upper extremity amputations except for shoulder disarticulation and forequarter amputations, for which. Amputations are all too common, accounting for 11% of all agricultural related injuries. Shoulder disarticulation amputation at the level of the shoulder, with the shoulder blade remaining. Participants will be able to identify common causes for upper and lower extremity amputation and demonstrate an understanding of the medical complications that require management throughout both the pre and post prosthetic phases of rehabilitation. Upper extremity amputations largely follow the same basic principles as those of any amputation. Introduction major upperextremity amputees account for only 8% of the 1. Amputee rehabilitation lynn cunningham, pt, dpt helena lax, md mark nielsen, cp, atc. Of those, 16 percent 3,225 had a major upperlimb amputation, which is a procedure at the wrist level or higher on the arm. The lectures have been compressed, for ease of download.
Saving the most distal joint possible dramatically improves the amputees function. Rehabilitation of upper extremity amputation algorithm vadod. Department of veterans affairsdepartment of defense vadod clinical practice guideline for the management of upper extremity amputation rehabilitation. Ottobock offers complete upperlimb prosthetic solutions for every amputation level and every needfrom industry leading aboveelbow designs and proven bodypowered solutions to incredibly realistic prosthetic gloves and custom silicone prostheses. Select a limb loss level below to narrow these listings. To view power point presentations for download, click here. Upper extremity amputation rehabilitation program mossrehab. When certain movements are performed, such as shoulder flexion raising your arm in front of you, tension is placed on the cable and the terminal device is opened. This will entail dividing all structures spanning from the proximal limb to the distal segment being amputated. Surgical goals include removing the damaged or diseased limb, minimizing longterm complications, and preparing a limb stump that can be fitted for a prosthetic.
Management of upper limb amputations sciencedirect. The most common accidents that contribute to upper body amputation are traffic accidents, farm and lawnmower accidents, and firearm and firework accidents. The management of upper extremity amputation rehabilitation group. This depends in large part on the degree to which individual counseling for significant psychological complications is necessary. The management of upper extremity amputation rehabilitation. Engagement in videogame play has become a popular meaningful occupation for clients today. The level of upper extremity amputation is the most important determinant of post amputation function. These devices may or may not also serve a cosmetic purpose. Additional notes and information are provided by many authors in the meeting notes section of. In fiscal 2016, 22 percent 20,158 of the veterans who received amputation care at va facilities had experienced an upperlimb amputation. Rough hands, smooth hands, plump hands, thin hands like wrinkled apple skin. In some ways, it can be more devastating than a lower extremity amputation. Longterm goals of upper extremity amputation rehabilitation care while the pathophysiology of traumatic amputations may be different than nontraumatic amputations, rehabilitation strategies and prosthetic component prescriptions for both should be centered on realistic patient goals with concentrated efforts directed to maximize function. This article highlights the special considerations involved in acquired amputations at or above the elbow.
At the upper extremity clinic at the university of michigan, we offer complete, compassionate care, taking you from the amputation process to getting you back to daily living by listening to your needs, providing you a thorough education and utilizing the most current therapy and prostheses available. Etiology trauma most common vascular disease malignancy infection zieglergraham k, mackenzie ej, ephraim pl, et al. Vocational handicaps and rehabilitation for upper extremity amputation 3 rehabilitation time may range from as few as 12 to as many as 38 weeks in the instance of the amputee capable of returning to similar work. Characterisation and outcomes of upper extremity amputations. Major upperextremity amputees account for only 8% of the 1. Because medical comorbidities leading to limb loss most often imperil the lower extremity, more lower limb than upper limb amputations occur, at a ratio of almost 5 to 1. Participants will be able to identify each phase of rehabilitation for the. The risk of limb loss increases with age greatest risk is age 65 and above.