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OBJECTIVES

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At the end of this chapter, all students are expected to:

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  1. Describe the major causes of upper limb amputations.

  2. Briefly describe upper-limb amputation surgery.

  3. Recognize the function of major upper extremity components.

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Physical Therapy students are expected to:

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  1. Establish a physical therapy diagnosis for a simulated upper limb amputee.

    1. Determine what information is necessary to establish a diagnosis.

    2. Design a plan of intervention based upon the diagnosis.

  2. Describe the major components of an upper extremity training program.

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Physical Therapist Assistant students are expected to:

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  1. Participate in implementing a program of intervention.

  2. Determine what guidance is needed from the supervising physical therapist.

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CASE STUDIES

Hector Rodriguez, a 41-year-old carpenter, sustained a left long transradial amputation when the safety cover broke off the band saw he was operating. Attempts to reattach the hand were unsuccessful. He is referred to physical therapy 24 hours after amputation. He has an immediate postoperative cast on his lower arm anchored just above the olecranon.

Laura Tyler, a 27-year-old Air Force helicopter pilot, lost her right arm at the transhumeral level secondary to a helicopter crash in Florida. During surgery, an angulation osteotomy was performed, and the residual limb was casted with a figure-eight suspension to maintain the cast in position.

Case Study Activities
  1. What data would be needed for each of these patients to establish an appropriate physical therapy diagnosis?

  2. What kind of emotional response and questions can you anticipate from each person?

  3. What are the critical elements of the postsurgical program for each of these individuals?

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The majority of upper limb amputees are treated by occupational therapists. However, on occasion, an upper limb amputee may be referred to a physical therapist when no occupational therapist is available. The purpose of this chapter is to provide a brief overview of upper extremity amputations and rehabilitation. Physical therapists involved with upper extremity amputees should refer to more detailed sources and consider taking continuing education courses in this area.

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Upper limb amputations are a small percentage of the total amputations performed in the United States but a majority of amputations performed for trauma.1 Physical therapists and physical therapist assistants may not treat many individuals with upper limb loss; however, they need to understand the basic concepts for those occasions when they treat an individual with such an amputation. An upper extremity amputation has a major impact on the individual's physical, social, vocational, and emotional life. In some ways, it can be more devastating than a lower extremity amputation. Figure 10.1 outlines the major levels of upper extremity amputation.

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Figure 10.1.

Upper extremity amputation levels.

Graphic Jump Location
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Amputations can occur at every level from the loss of a phalanx to the loss of the entire upper limb. Trauma of all ...

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