Amputation Of Upper
Arm And Shoulder
An amputation above the elbow should be
designed to preserve as much length of the residual limb as possible. To
function successfully, an artificial upper limb must have a long lever arm and
as much of the humerus as possible should be saved to provide this lever (see
images at top of page). Even a very short humerus stump should be retained if
possible, because disarticulation of the shoulder greatly diminishes the
powering of the artificial limb.
Occasionally, a kineplasty technique
is used to enable the patient to operate the terminal device of an upper limb
prosthesis. In this procedure, a tunnel is made beneath the biceps brachii
muscle and the entire tunnel is covered with skin, creating a loop of muscle.
The cables for the operation of a terminal device of an upper limb prosthesis
are attached to this muscle loop.
Forequarter Amputation
This radical procedure is usually
reserved for the treatment of aggressive, malignant tumors. In contrast to the
disarticulation of the shoulder joint, a forequarter amputation removes all of
the bone architecture and muscles of the upper limb (see images at bottom of
page). It is a devastating amputation that provides no residual base to support
an artificial limb. Consequently, it is usually very difficult to obtain a
satisfactory fit of the prosthesis.
