The Bilateral Upper Extremity Amputee

Abstract

Summary 1. Prosthesis acceptance in the bilateral upper amputee is directly proportional to the increase in efficiency afforded the patient by the device. The prosthesis must not impair feedback and, if possible, should provide some actual feedback or an adequate substitute. The patient's manipulative abilities must be given priority and not reduced, if at all possible, by the prosthesis. 2. The bilateral upper extremity amputee with acquired defects requires great support in the immediate postinjury period to combat reactive depression and needs extended care for rehabilitation. In the case of a congenital bilateral shoulder disarticulation, it is the parents and family that need the initial support. 3. In the patient with a bilateral shoulder disarticulation the use of external power is finding justifiable acceptance. Myoelectric control is particularly useful in the elbow control units in the bilateral above elbow amputee.4 4. In a case of bilateral upper extremity amelia with normal lower extremities the patient should be taught early in the first year of life to manipulate his torso and lower extremities in order to insure ultimate function with or without a prosthesis. 5. The tragic patient with quadrimembral amelia is a prime candidate for the use of external power, and research priorities should be directed toward these patients with high amputation levels. Perhaps research into the socioeconomic aspects in these patients should be our first concern.20