The primary reason for upper limb loss is trauma and the next most common cause is cancer. The level of upper-extremity amputation is the most important determinant of post-amputation function. One of the primary goals of surgery is to save as much of the limb as possible. Saving the most distal joint possible dramatically improves the amputee's function.
The major levels and types of upper-limb amputations are:
- Hand and Partial-Hand Amputations: Types of partial hand amputation include finger, thumb or portion of the hand below the wrist. All hand amputation types can lead to a need for complex rehabilitation therapy. The Hand Center at MossRehab is there to help, providing expert rehab for all levels of hand injury including partial hand amputation. We offer individualized treatment from the acute injury phase through return to work.
- Wrist Disarticulation Amputation: The limb is amputated at the level of the wrist. Wrist disarticulation involves the removal of the hand and the wrist joint. Generally, the patient is left with forearm muscles, which allows for the ability – following rehab - to rotate and maneuver a prosthetic hand. MossRehab’s Hand Therapy Center can work with patients to rehab after injuries or surgery and to fit and learn to use prostheses, when appropriate.
- Transradial (below elbow amputations): Any amputation that occurs in the forearm, from the elbow to the wrist. These types of amputations are generally caused by trauma, most commonly crush injuries. Infections, tumors and congenital defects can also lead to the procedure. MossRehab’s Hand Therapy Center can work with patients to rehab after injuries or surgery and to fit and learn to use prostheses, when appropriate.
- Transhumeral (above elbow amputations): Any amputation that occurs in the upper arm from the elbow to the shoulder. These amputations typically result from injuries. MossRehab’s experts can help with determining whether a prostheses is appropriate.
- Shoulder Disarticulation Amputation: An arm amputation that is at the level of the shoulder, with the shoulder blade remaining. The collarbone may or may not be removed. Arm amputation at the shoulder usually leaves the patient with some shoulder movement, leaving options for a protheses. MossRehab’s experts can help with determining whether a prostheses is appropriate.
- Forequarter Amputation: A shoulder disarticulation amputation in which the shoulder blade and collar bone are removed, leaving little ability to move the shoulder. MossRehab’s experts can help with determining whether a prostheses is appropriate after this type of shoulder amputation.
Upper Limb Amputation Rehab at Mossrehab
Because upper-limb amputations are less frequently seen, many hospitals have little or no experience in treating this condition. It is important to receive care from an experienced team who is familiar with all of the treatment options for persons with upper-extremity amputation.
At MossRehab, the upper-extremity team consists of occupational, recreational and physical therapists; psychologists; social workers; nurses and the prosthetist. A physiatrist (rehabilitation doctor) leads the team. Each patient's upper extremity rehabilitation program is tailored to his or her specific needs. You may work with each of the above team members or only one or two, depending on your individual needs.
We are experienced in working with both body-powered and electric upper-extremity prosthetics. Our treatment goal is to return people to independence through occupational therapy, physical therapy, and other support services so they can care for themselves, participate in hobbies and recreation, and return to work.
Many of our programs can be completed on an outpatient basis or in a more intensive Day Program.