UE Amputation

Question 1

UE Amputation Etiology

Answer 1

90% d/t trauma
10%, PVD, tumor, infection, congenital
Soldiers
M between ages 20-40

Question 2

Surgical Issues Impacting Functional Outcome

Answer 2

Optimal skin closure & healing (Revision needed) 
Contour of residual ms bellies 
Prevent neuroma 
Adequate vascular supply (Critical) 
Rounded distal edges 
Preserve joint ROM

Question 3

Prosthetic use requires…

Answer 3

A cone shape (usually the revision surgery)

Get pt. into prosthetic ASAP increases compliance & acceptance

Question 4

Neuroma

Answer 4

Collection of nerve tissue that is painful (not phantom pain)

Question 5

Pre-posthetic Management

Answer 5

Wound healing (closures, decrease infections)
Pain management (allow pt. to control therapy_
Edema control (for prosthetic)
Skin care & desensitization (sensory massage)
Stump shaping
ROM/Strength (theraband)
Psychological adjustment
Education re: prosthetic choices

Question 6

Pain Desensitization

Answer 6

Deep pressure, pt needs to tolerate deep pressure to use prosthetic w/o pain

Question 7

Early Prosthetic Management

Answer 7

Prosthesis w/in 1st 30 days of amputation have greater acceptance of prosthesis than those fit after 30 days

Question 8

Levels of UE amoutation

Answer 8

Forequarter (lose scapula) 
Sh. disarticulation 
AE 
Elbow disartic. 
Short BE 
Standard BE 
Wrist disartic. 
Partial hand 
Digit (decreased functional prosthesis, cosmetic gloves)

Question 9

Digit & Partial Hand Amputations

Answer 9

Can place prosthetic digit over remaining fingers
Cosmetic glove
Surgically recreate digits
Single digit amputation = no therapy needed

Question 10

Wrist Disarticulation & Transradial Amputation

Answer 10

Majority of UE prosthesis designed for this population (hook)

Question 11

Elbow Disarticulation

Answer 11

Medial & Lateral epicondyles

Assist w/ suspension of prosthesis

Question 12

Transhumeral

Answer 12

50-90% of humerus remains
Short AE
Long AE

Question 13

Shoulder disarticulation & forequarter amputation

Answer 13

At GH jt. w/ scapulothoratic jt. in place
Functional prosthetic replacement is difficult
Passive prosthesis for a symmetric and cosmetic apperance

Question 14

Hook Prosthesis

Answer 14

Functional 
Uses sh. power 
can get wet 
timeless 
practical 
voluntary opening/closing 
Can be bent into wrist (flexion, extension, sup or pronation) 
Good visability

Question 15

Phantom Sensation

Answer 15

Perception of presence of amputated limb
common in traumatic amputations (feels like you arm is in the position it was amputated in)
Intact neural system in brain even w/ absence of limb

Question 16

Role of OT w/ Myoelectric Controls

Answer 16

Help develop isolated control of flexors and extensors

Question 17

Advantages of UE Prosthetics

Answer 17

Body image 
Provides non-dominate hand 
Enhances bimanual activities
Accelerates function 
Indep if loss of other limb occurs

Question 18

Disadvantages of UE Prosthetics

Answer 18

Sensory feedback and movement can be impeded
Comfort can be compromised
Skin reaction
Frequent visits to prothetist & OT