Immediate Postsurgical Management of Upper- Extremity Amputation: Conventional, Electric and Myoelectric Prosthesis

Approximately 6-10,000 upper-extremity amputations are performed each year in the U n i t e d S t a t e s ( 6 , 9 , 1 8 ) . S u c c e s s f u l r e h a b i l i t a t i o n a f t e r u p p e r e x t r e m i t y amputation has significant economic impact both to the amputee and society, since most upper-extremity injuries occur in young working males (5,11). Although the success rates for fingertip, finger, and hand replantation exceed 9 0 per­ cent in most centers, the success rate for replan­ tation above the wrist averages 50 percent or less in most institutions (2 ,4 ,8 ,13,14) . The current success rate for rehabilitation after upper-extremity amputation with fitting of conventional prosthetic devices is 50 percent or less (1,3,5,7-9,15) . Although slightly more than 100 cases of rapid or immediate post­ surgical prosthetic fitting after upper-extremity amputation have been reported, there appears to be a relative lack of interest in this area (9). In addition, although there have been many significant improvements in the quality, func­ tion, and reliability of externally powered upper-extremity prosthetic devices during the last five years, most of this technological ad­ vancement has been lost on contemporary surgical and prosthetic care. The purpose of this report is to review our experience with upperextremity immediate postsurgical fitting utiliz­ ing conventional, electric, and myoelectric components.