Six Prosthetic Options

There are six basic prosthetic options to consider for the upper-extremity amputee and the type of prosthesis selected/suggested/recommended is based on many factors, including level of amputation, condition of residual limb, individual goals and work requirements. Often more than one option may be required for an individual to accomplish all of his or her goals. Personal requirements may be function-related, cosmetic or psychological in nature. Following is an overview of the six prosthetic options:

No Prosthesis
Not every person is a candidate for a prosthesis, and even if he or she is, many choose not to wear or use one. Only half of all upper-extremity amputees ever receive prosthetic services. Of those, as many as half choose not to use or wear their prosthesis one year from initially receiving it. For many amputees, their level of function is simply not enhanced by the use of a prosthesis. Also, some amputees who cannot obtain funding are provided with a prosthesis that does not address their individual needs, or had a poor first experience that may have included pain, discomfort and poor function; and thereafter, choose not to pursue further prosthetic care.

Cosmetic Restoration
Cosmetic restoration, or duplication of the contralateral arm or hand, is a popular prosthetic option. This involves replacing what was lost from amputation or congenital deficiency with a prosthesis that is similar in appearance to the non-affected arm or hand and provides simple aid in balancing and carrying.

Body-Powered Prosthesis - A body-powered prosthesis, sometimes called a conventional prosthesis, is powered and controlled by gross body movements. These movements, usually of the shoulder, upper arm or chest are captured by a harness system, which is attached to a cable that is connected to a terminal device (hook or hand). For some levels of amputation or deficiency, an elbow system can be added to provide the patient additional function.

Electrically-Powered Prosthesis
This category of prosthesis uses small electrical motors to provide function. These motors can be found in the terminal device (hand or hook), wrist and elbow. This type of prosthesis utilizes a rechargeable battery system to power the motors. Because electric motors are used to operate hand function, grip force of the hand is significantly increased, often in excess of 20-32 pounds.

Hybrid Prosthesis
A hybrid prosthesis combines body power and electrical power in a single prosthesis. Most commonly, hybrid prostheses are used for individuals with transhumeral (above the elbow) amputations or deficiencies.

Activity-Specific Prosthesis
Activity-specific prosthesis is designed specifically for an activity in which the use of a passive, body-powered, electrically-powered or hybrid prosthesis would place unacceptable limitations on function or durability. Often this type of prosthesis is recreational in nature for activities such as fishing, swimming, golfing, hunting, bicycle riding and weight lifting, but prostheses have been created for such activities as music and work-related tasks.