Prosthetic Options for Wrist Disarticulations

Wrist disarticulation level is the medical term that’s used when all of the structures of the hand are absent due to a congenital limb difference or an amputation. With this type of limb difference, it used to be challenging to fit a functional prosthesis that was the right length. Fortunately, over the last ten years, manufacturers have standardized shorter wrist connections. That makes it possible to select prosthetic components based on the person’s lifestyle and goals while keeping the device at the optimum length.

Our patient Tom Seibert (pictured above) has a wrist disarticulation amputation. As a senior in high school, he was injured in a wakeboarding accident that eventually led to his hand being amputated. Tom’s prosthetist had to solve a tricky problem. He needed to create a prosthesis that kept Tom’s affected arm the same length as his sound arm, but since the amputation was at the wrist, there wouldn’t be much room for a terminal device. You can see how long Tom's residual limb is in the photo below (and that he didn't let his amputation stop him from wakeboarding!). For his everyday prosthesis, Tom has a multi-articulating TASKA hand with a low-profile wrist that doesn’t take up extra space. There is a downside worth mentioning: low-profile wrist connections are not “interchangeable” with other terminal devices. That’s why Tom has a second, activity-specific prosthesis that has no batteries or electronics, with several different attachments that connect to it for fishing, paddleboarding and more.

Another myoelectric option is the ETD2 — it’s a shorter version of the ETD (electronic terminal device). Because the ETD2 is more compact, it can be helpful for those with longer residual limbs, especially when coupled with a low-profile wrist connection. Body-powered prostheses are another option for people with a wrist disarticulation. Here, the hook and wrist combination prevents the prosthesis from being too long. Passive prostheses are another option — they can only be moved or positioned with help from the sound hand. That's because there are no mechanical parts to add unwanted length.

Our Arm Dynamics clinicians consider all the options when fitting someone with a wrist disarticulation prosthesis. We discuss our patients’ goals and plans with them to get the best understanding of how we can help. Years of experience working exclusively with upper limb patients allows us to optimize each person’s prosthetic outcome. We apply our proprietary outcome measures to make sure each patient has the best possible prosthetic rehabilitation. We offer custom silicone sockets that maximize comfort, and provide unique suspension designs especially for people with wrist disarticulations.

Are you interested in learning how we can help you or someone you know be fit with a wrist disarticulation prosthesis? Just contact us. If you have a wrist disarticulation level amputation or absence and have found success with a prosthetic device, we would love for you to leave a comment below. Thanks for reading!

For more information, see related Arm Dynamics articles here:

• Terminal Device Overview
• Introduction to Multi-Articulating Myoelectric Hands
• An Introduction to Activity-Specific Prostheses
• Fishing with a Prosthesis
• Introduction to the ETD2