- See: Upper Extremity Prosthetics:
- Discussion:
- below-elbow amputation is extremely functional, and successful prosthetic rehabilitation and sustained use are achieved in 70% to 80% of patients;
- forearm rotation and strength are proportional to length retained;
- Long Below Elbow Stumps:
- in long elbow stump w/ equal length of ulna & radius, larger radius might be kept 1-2 cm longer than ulna, but never the opposite;
- in short stumps, the ulna might be somewhat longer than the radius;
- Short Below Elbow Amputation:
- Congenital:
- most common congential amputation;
- radial head is always dislocated in congenitaal cases;
- Traumatic:
- in adult, even a short BEA stump 3.8 to 5 cm is preferable to an amputation thru or above the elbow joint;
- the shorter the stump, the better it is to be covered by muscles;
- clearly the lever arm is diminished;
- using a munster or a split socket w/ step up hinges, an excellent prosthetic fit can be obtained;
- short below elbow stump is still useful as long as insertion of biceps remains intact;
- it can be transposed more proximally to radial head, thus increasing contact surface of the stump to facilitate prosthetic fitting;
- consider resection of distal biceps insertion, if the end of the stump is not distal to insertion of the biceps on the radius;
- this improves prosthetic fit, & brachialis flexes OK
Impact of Prostheses on Function and Quality of Life for Children with Unilateral Congenital Below-the-Elbow Deficiency