Above the Elbow Limb Differences

While transhumeral, more commonly known as above-elbow amputations, can present many of the same complications as shoulder amputations, there are definite benefits to having a physical shoulder joint and some of the upper arm left. It’s helpful in positioning the prosthesis in space (expanding your work area), doing tasks without a prosthesis and it can allow for more “typical” body profile/silhouette. Nevertheless, any level of traumatic amputation is devastating and congenital above-elbow limb differences can also be difficult to cope with.

There are quite a few prosthetic options for people with an above the elbow limb difference. The Arm Dynamics clinicians will guide you through the process of deciding which option is best for you by evaluating your residual limb, discussing your personal and professional goals, and showing you examples of different prosthetic options. To create a prosthesis for this level of amputation, you need to have the socket, the elbow, the forearm, the wrist (if present) and the terminal device, and those all have to work together. You can watch Claudia Castenellos don her prosthesis in her patient profile video:

One cause of above-the-elbow amputations are ATV accidents. Several of our patients lost their arms that way: Lloyd Keith, Diana Gazzano and Kate Jorgenson. We have also fit congenital amputees, like Max Okun. Max received his first prosthetic arm at age five, but it wasn’t a good fit for him, so he stopped wearing it and lived without a left hand. In his 20s, Max got interested in fitness and weight training, became a personal trainer, and began to experience serious overuse issues. That was when he started to look at activity-specific devices, one of numerous options available to people with this level of amputation.

In the U.S., around 90 percent of amputations are lower limb. That means only about 10 percent of amputations impact the upper limbs and the majority of those involve finger and partial hand amputations.This means it’s very challenging for upper limb amputees to find a prosthetist that has significant experience fitting a transhumeral prosthesis that’s functional and comfortable – unless they come to an Arm Dynamics center.

We are the only prosthetic care centers that focus solely on upper limb differences and our team of prosthetists and clinical therapy specialists have years of experience in upper limb prosthetic rehabilitation. It’s important for patients to be sure that their prosthetist is qualified.

In high-level amputations, a surgery called Targeted Muscle Reinnervation (TMR) can be of help. During a TMR procedure, the surgeon works with available nerves – the nerves that, before amputation, fired the muscles and activated movement of the limb. Those nerves are reassigned to the remaining muscles in the residual limb. This surgery can allow for better control of a myoelectric prosthesis and reduce phantom limb and nerve pain. In addition, because we have helped thousands of people with this level of amputation, we can connect new amputees with our current patients who are part of our Peer Support Network.

If you or someone you know has an above the elbow amputation or a high-level congenital limb difference and would like to learn more about how we can help, please contact us. If you have an above the elbow limb difference and would like to tell your peers about it or share some encouraging words, we invite you to leave a comment below. Thank you!

For more information, see related Arm Dynamics articles here:

• Featured Patient: Lloyd Keith
• Overuse Issues for People with an Upper Limb Difference
• An Introduction to Activity-Specific Prostheses
• Seven Reasons Arm Dynamics Centers Are Different From Other Prosthetic Care Providers
• Introduction to Targeted Muscle Reinnervation (TMR)