Current Concepts in Upper-Extremity Amputation

J Hand Surg Am. 2018 Jul;43(7):657-667. doi: 10.1016/j.jhsa.2018.03.053. Epub 2018 Jun 2.

Abstract

Advances in motor vehicle safety, trauma care, combat body armor, and cancer treatment have enhanced the life expectancy and functional expectations of patients with upper-extremity amputations. Upper-extremity surgeons have multiple surgical options to optimize the potential of emerging prosthetic technologies for this diverse patient group. Targeted muscle reinnervation is an evolving technique that improves control of myoelectric prostheses and can prevent or treat symptomatic neuromas. This review addresses current strategies for the care of patients with amputations proximal to the wrist with an emphasis on recent advancements in surgical techniques and prostheses.

Keywords: Primary amputation; prosthetics; reinnervation; surgical reconstruction; upper extremity.

Publication types

  • Review

MeSH terms

  • Amputation, Surgical*
  • Artificial Limbs
  • Clinical Decision-Making
  • Electromyography
  • Free Tissue Flaps
  • Humans
  • Muscle, Skeletal / innervation
  • Neurofeedback
  • Neuroma / etiology
  • Neuroma / surgery
  • Osseointegration
  • Peripheral Nerves / transplantation
  • Postoperative Complications
  • Prosthesis Design
  • Soft Tissue Neoplasms / etiology
  • Soft Tissue Neoplasms / surgery
  • Upper Extremity / injuries*
  • Upper Extremity / surgery*