Comprehensive Management of the Upper-Limb Amputee

Book excerpt: Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later.