Myoelectric immediate postsurgical procedure: a concept for fitting the upper-extremity amputee.

The advantages of immediate postsurgical fitting in the management of upperextremity amputees have been pointed out by Sarmiento et al. (4) and Loughlin et al. (3). These advantages, which are similar to those for the lower-extremity amputee, are: reduction of postoperative pain, control of postsurgical edema, early use of a prosthetic appliance, early psychological adjustment to the disability, reduction of hospitalization time, and, hopefully, a higher rate of prosthesis acceptance by the amputee, particularly the unilateral amputee. Thranhardt (1) has confirmed the psychological and economic advantages of this procedure and has suggested that the problems of adapting present upper-extremity components for use with rigid dressings be examined. It would seem that almost any upperextremity component could be adapted for use with rigid dressings. Indeed, it would appear that externally powered devices, if they offer significant benefit to the patient, could be used as well as body-powered units. One of the authors (Hampton) suggested that an externally powered prosthetic appliance, controlled myoelectrically, might be used to significant advantage with immediate postsurgical fitting of the upper-extremity amputee. The application of myoelectric control would encourage the early use of muscles remaining in the stump, which should improve circulation and reduce stump muscle atrophy. This paper summarizes the experience of the authors with the immediate postsurgical fitting of myoelectrically controlled prostheses. One primary amputation and a stump revision have been managed in this manner with very satisfactory results.