With amputations in the arm area, greater functional and psychological disorders occur compared to the lower extremity.
It is also more difficult to provide an optimal prosthetic restoration, since the requirements for mobility cannot be met by the prosthesis in the same way as those for stability.
The more extensive the limb loss, the more often arm amputees do not accept the prosthetic treatment; in the case of unilateral amputation at the level of the shoulder (shoulder disarticulation), the prosthesis is usually rejected.
Task of Upper limb prostheses is primarily the assumption of the gripping function, but without the important feedback via sensation (sensitivity).
A certain sensory feedback, i.e. the perception of stimuli, can be achieved with conventional prostheses through the force-transmitting parts.
About a Cable pull If the gripper arms are active, the force can be transferred from a bandage to the handpiece. This possibility exists at External force prostheses with an electric drive, of course, they are characterized by cheaper cosmetics than good function.
Should only those cosmetic needs are satisfied, are also available Jewelry hands or Jewelry arms to disposal.
The prosthetic restoration, albeit functionally poor, in the case of bilateral shoulder disarticulation, as can occur after an explosion injury, is indispensable in order to achieve a sufficient functional result.
The Problem of the rotationally stable (rotationally stable) prosthesis exists above all in upper arm amputations, since the prosthesis shaft can often only be stabilized with difficulty on the cylindrical upper arm cross-section.
In some cases, operational measures are necessary, such as bending of the outer (distal) end of the residual limb in long humerus residual limbs to facilitate attachment. Active gripper arms are preferred here:
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For one Forearm amputation on the other hand is special one myoelectric prosthesis suitable, especially when the ability to rotate the forearm is preserved.
This is External force prostheses, where with each contraction the Muscles on the skin an electrical voltage is created that is used to control this electrical prosthesis.
As an alternative to treating long forearm stumps, the Krukenberg technology, in the Cubit and spoke be separated from each other with a soft tissue jacket like scissors and thus a gripping function is maintained between the two bones while maintaining sensitivity (sensitivity).
Prosthetic restorations are not possible in the hand area. Most likely, operative, restorative (reconstructive) measures to build up the hand as an accessory or to improve the gripping function Toe transplant in question.
In the area of the lower extremities, amputations from the hip joint (hip disarticulation) or amputations of the lower half of the body (hemicorporectomy) after tumor disease are particularly problematic.
The ability to walk can only be retained in younger patients after such procedures. For this, it is necessary to embed the fuselage in a raised plastic basket. The application of force for such a prosthesis occurs via the so-called ischial tuberosity (tuber ischiadicum), a dominant bone protrusion on the upper edge of the ischium.
Due to the lightweight tubular skeleton structure, the prosthesis is widely accepted. In the area of thigh amputations, myoplastic prostheses are used in order to be able to control the stump position through the thigh muscles (quadriceps and hamstring muscles).
Myoplastic treatment means that the stump has been well covered with soft tissue and the muscle groups have been fixed in order to ensure that the stump is actively guided.
In most cases, however, a complete end loading of a thigh stump is not possible. That is why the force must be introduced into the prosthesis via the ischial tuberosity.
The knee joint can be controlled electronically. Lower leg amputations and knee joint disarticulations are largely capable of full stress, i.e. end of stress.
Here the introduction of force can be taken over by the two prosthesis shafts, which enable full contact with the residual limb.
Even with amputations in the ankle and foot area, a full load is sought, which is provided with a short prosthesis. In the case of amputations of the metatarsus or forefoot, only shoe adjustments are required
Read more on the topic: Thigh amputation
