Losing a limb or losing function of a limb is difficult no matter the circumstances, but for those with upper-limb amputations or impairments, it can be particularly difficult due to the types of tasks for which we use our arms and hands. In this regard, patients often require more than one type of O&P solution, and clinicians may need to tap into their creative processes to meet those needs.
“A Device for Every Season…or Every Activity” addresses the need for people with upper-limb loss to have different terminal devices or even different types of prostheses for the variety of tasks needed to live healthy, well-rounded lives, from activities of daily living to hobbies and recreational pursuits. The experts in this article explore some of the current options available—including a brace for patients with hand dysfunctions or spinal injuries that can be coupled with prosthetic terminal devices—and they offer tips to document the reimbursement justification for multiple prosthetic solutions for patients.
An upper-limb presentation that few practitioners encounter is a forequarter amputation. “Success at the Highest Level: Achieving Function and Aesthetics With an Interscapular-thoracic Prosthesis," introduces us to Sam Rosecrans, who lost his right arm and shoulder in an industrial accident. This article provides a striking example of the variety of solutions one patient may require to return to a robust life. In Rosecrans’ case, this included his request for a futuristic-looking prosthetic shell paired with a Steeper bebionic hand for social situations, and a Motion Control Electric Terminal Device for work and outdoor activities. As Kerstin Baun, MPH, OTR/L, explains, we don’t wear the same type of footwear for all activities, so it makes sense that patients need terminal devices suited to different activities.
In “Improving the Human-machine Interface: Revolutionary Advancements in Upper-limb Prostheses,” Phil Stevens, MEd, CPO, FAAOP, explores advances in control mechanisms, sensory input, and suspension methods, including osseointegration. The combination of these advances may indeed give rise to a future in upper-limb prosthetic technology that overcomes the limitations that have long frustrated users.
Like many people with an upper-limb amputation, Jake McGehee, the subject of this issue’s Today’s Consumer, has discovered ways to accomplish many of his normal tasks without using a prosthesis or with only part-time wear. But to return to his musical passion, he needed the help of his prosthetist and a creative, activity-specific solution.
The myriad solutions, possibilities, and people in this issue devoted to upper-limb O&P have inspired me as we kick off the new year, and I hope that these articles will inform, and perhaps inspire, you too. Happy reading.