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Upper Limb Prosthetic Options & Alternatives

Contrary to what many people think, there are usually many different arm prosthetic options available to upper limb amputees. Depending on a variety of factors (like the level of amputation, your lifestyle, etc.), you have different options of prosthetics specialized for different needs. For example, some prosthetic devices can be customized with different attachments to allow you to continue with your favorite outdoor hobbies, like golf or archery. The important thing to remember is that you have options and should not settle for anything that isn’t the right for you. 

With that in mind, below are some of the most common options that upper extremity amputees choose.

Passive prosthesis

Passive arm prostheses are the best option for people who want their prosthetic to be functional and look more life-like. Passive prostheses are made out of different definitions of silicone, either high-definition or low-definition. While most offer limited grasping ability and the ability to pre-position the hand, these are primarily chosen for aesthetic purposes and are not as functional as some of the options below. In addition to passive hands, we have experience with new 3D-printed steel and titanium finger technologies that are very promising, including products from Point Design and Titan Hand Solutions, which are great solutions for people with partial finger amputations.

Body-powered prosthetics

Body-powered prosthetics are typically a prosthetic hook or hand that is operated by a combination of the body harness, upper-body muscles and the individual’s sound limb, all connected with a cable. Shifts in the harness and muscle tension pull on the cable, allowing the wearer to open and close the hook or hand. Because of the way these cable-operated prosthetics work, the wearer has the advantage of feeling feedback about the amount of pressure they are applying with their hooks or hands.

The hooks and hands in body-powered protheses come in two default states: voluntary open and voluntary close, which refer to whether or not the device is open or closed by default. While hands can look more natural, it’s important to consider the advantages that hooks have. For example, hooks are especially useful for bilateral amputees, and allow easy access into pockets and bags. 

Externally powered (myoelectric) prosthetics

These prosthetics use microprocessors to amplify EMG signals from your muscles, allowing you to control the wrist or hand. The term “myoelectric” is used to describe the electrical impulses in your muscles, which are processed by the prosthetics to allow the wearer a near-natural range of motion. These prosthetics can combine the natural look of passive prosthetics with a high degree of functionality and control and are therefore some of the most popular. 

While some of the older versions of these devices have high grip strength (oftentimes applying up to 20-30 pounds of force), more advanced versions generally offer less grip strength. Rather than strength, the latest devices are focused on advanced pattern recognition, which allows myoelectric prosthetics to understand and execute cues faster than traditional technologies. 

Hybrid prosthetics

Hybrid prosthetics combine body-power and myoelectric control to give the user the ability to control the elbow and hand simultaneously. Hybrid prosthetics also combine the high grip force of a myoelectric device with the bio-feedback of body-controlled devices, without extra bulk.

Activity-specific prosthetics

These are devices made for a specific activity, like fishing or swimming. Common activity-specific attachments also exist for a variety of day-to-day tasks such as brushing your teeth, combing your hair, and more. MCOP generally recommends attachments from TRS or Texas Assistive Devices, both of which offer great products for almost any application. 

Advanced and “experimental” technology

This is the cutting-edge front of prosthetic technology, relying on the latest smart technology combined with the most advanced materials. These include:

  • Implantable myoelectric sensors (IMES), which allow for very fine control of externally powered prosthetics
  • The DEKA/LUKE arm, now manufactured by Mobius
  • Modular Prosthetic Limbs (through the VA)
  • Osseo-integrated prosthetics
  • HAPTIX (Hand Proprioception and Touch Interfaces), which sends nerve signals back and forth from the terminal device.

MCOP works hard to stay at the fore-front of the latest in prosthetic technology, but we know that a lot of the above can be overwhelming and sometimes it’s easier to just talk to someone. If you have any questions, please don’t hesitate to contact us here.

Living without an arm prosthesis

Another option, of course, is to not wear a prosthetic, which we see in about half of upper extremity amputees. Generally, most people forego a prosthetic due to a bad experience they’ve had with older technology. However, the latest advancements make wearing a prosthetic more attractive than ever. With our modern approaches, over 80% of patients that we fit opt to use a prosthetic. Not only have prosthetics improved dramatically in the last few years, but not wearing a prosthetic has a number of major drawbacks, including:

  1. Overuse syndromes (carpal tunnel, etc.)
  2. Reduced function
  3. Unbalanced movements resulting in back or neck pain

If you or a loved one is considering an upper limb prosthetic you don’t have to make that decision alone. Our team at MCOP has extensive experience in upper limb prosthetics and we’re always happy to help. If you’re interested in getting expert support and guidance, you can call one of our experts here. When helping you understand your options we’ll cover a variety of topics to get to know you better. After that you can schedule an initial clinical assessment where you’ll have a specialist review your sound limb, current device, and your needs and goals so we can help you build your best path forward.

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