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The goal in fitting an upper limb amputee with an arm prosthesis is to replace the lost function and appearance of the missing limb. This ideal is easily stated and obvious yet it is exceedingly difficult to accomplish. The human hand is a highly sophisticated and beautiful tool. It provides an abundance of information regarding the world around us. It offers us the means by which we interact with our environment. The texture and temperature of objects, the speed and force of the hand's movements are all reported back to the brain almost instantaneously and subconsciously. The hand is not only a superbly adept manipulator of our environment, but also a powerful tool for communication. The hand can be used to augment the meaning and "feeling" behind the spoken word or it can sometimes take the place of words, serving as a primary communication tool as in a caress or embrace. (Uellendahl 2000)
In all cases of acquired arm amputation it is advisable to fit a prosthesis as soon as possible after amputation, preferably within the first 30 days. The period of 30 days after amputation has been referred to by Malone as the "Golden Period". There are multiple advantages to early postoperative fitting, these include decreased edema and pain, accelerated wound healing, improved rehabilitation, decreased length of hospital stay, increased prosthetic use, maintenance of some continuous type of proprioception input through the residual limb, and improved patient psychological adaptation to amputation (Malone JM, Fleming LL, Robertson J, et al: Immediate, early, and late postsurgical management of upper limb amputations. J Rehabil Res Dev; 21:33-41,1984)
The field of upper limb prosthetics is small, accounting for approximately 10 percent of the overall amputee population. In choosing a prosthetist it is important that one be selected with sufficient experience in fitting arm amputees who will be able to guide the user regarding all types of designs and control systems. The selection of the most appropriate prosthetic arm system can be very complicated. There are a multitude of hands, elbows, hooks and special adaptors to choose from. Early on it is important for the amputee to learn about the components that may be useful to him/her and the best methods for controlling those components. After narrowing down the components and control options it is sometimes useful to "test out" the most appealing options using an evaluation or prototype prosthesis. This is an excellent way to decide upon the final design of the prosthetic system.
The use of an evaluation prosthesis allows the amputee to make selections regarding their prosthesis based on first hand knowledge and it allows the prosthetist to listen to the amputee as together they come to a design that will be optimal.
Often getting back to hobbies and recreational activities has a very positive impact. Here a transradial amputee uses his specially designed prosthesis for kayaking and moutain biking.
Mr. Uellendahl is internationally recognized as a leader in the fitting of upper limb clients. He has demonstrated unprecedented success in designing and fitting successful limb systems for high level and bilateral arm amputees. Through Hanger Prosthetics Upper Extremity Program he has the resources of the largest provider of prosthetic services in the world including dedicated staff attending to insurance authorizations and other funding requirements. He continues to participate with key manufacturers who look to his knowledge and expertise regarding product development and new research endeavors and is qualified to fit all manufacturers componentry.
Otto Bock Health Care: www.ottobockus.com
Motion Control, Inc.: www.utaharm.com
Liberating Technologies, Inc.: www.liberatingtechnologies.com
Animated Prosthetics, Inc.: www.animatedprosthetics.com
Variety Ability Systems, Inc.: www.vasi.on.ca
Hosmer: www.hosmer.com/products1.htm
TRS: www.oandp.com/products/trs/resources.htm
High definition silicone prostheses and limb covers offer the finest in life like appearance. Mr. Uellendahl has extensive experience working with the major silicone prosthesis manufacturers including:
LivingSkin: www.livingskin.com
Alatheia: www.alatheia.org
Hugh Steeper Ltd.: www.libertingtech.com
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