AMPUTATIONS: UPPER EXTREMITY

Amputations upper extremities 

An upper limb amputation is the removal of any part of the upper extremity by surgery, trauma or pathology.  Standard levels of amputation include removal of any part of the arm, forearm, hand or digits.  A major limb amputation is generally considered any amputation at or above the wrist. A disarticulation is an amputation through a joint, where the distal articulating bone is separated and removed from the proximal articulating bone. Typically there is no cut or damage to the full length of the remaining proximal bone. 

Cause

The leading cause of upper limb amputations is trauma occurring in males ages 15-25 years, followed by cancer/tumors (common cause of more proximal amputations such as a shoulder disarticulation or forequarter amputation), and then vascular complications of diseases. Another cause of upper limb amputations is correction of congenital anomalies.

Levels of Upper Extremity Amputations

Levels of upper extremity amputations include:

• Fingers or partial hand (transcarpal)
• At the wrist (wrist disarticulation)
• Below the elbow (transradial)
• At the elbow (elbow disarticulation)
• Above the elbow (transhumeral)
• At the shoulder (shoulder disarticulation)
• Above the shoulder (forequarter)

Diagnostic Process

Several tests may be performed to determine a patient’s need for upper arm amputation, including x-rays, MRI, CT and bone scans, and ultrasound. These tests evaluate bony structures, tumors, infection, blood flow, and nerve injury. Other special test includes electromyography/nerve conduction test (EMG/NCS). EMG/NCS can be helpful with finding potential nerve problems and determining muscle strength. These special tests are generally done by a PM&R physician, also known as a physiatrist