Shoulder Level Limb Differences

Shoulder level limb differences can be congenital or acquired. Shoulder level amputations are rare, but when they do happen, they are especially difficult on the patient, their family and friends. These types of amputations include shoulder disarticulations, forequarter and humeral neck amputations. These amputations are generally done because of tumor removals, complications from an illness or traumatic accidents.

We offer several devices for people with shoulder level limb differences. These include simple devices like a prosthetic shoulder cap or filler that fits into the space where the shoulder used to be and makes the person’s profile look more typical. At the other end of the spectrum, we fit people with a hybrid myoelectric arm, like Sam Rosecrans, who has a positionable, locking shoulder, a Utah arm elbow, and both an ETD and myoelectric hand. Watch him in the video below:

We’ve even participated in test fittings of our patients with the most advanced arm in the world, the LUKE arm.

The challenges that come with this level of limb difference include creating a prosthesis that generates enough force to power the elbow, wrist, and hand components. Shoulders do a tremendous amount of the work that’s required to move and use our arms. Recreating this ability with a prosthesis can be tricky.

Because so few people in the United States have a shoulder level limb difference, chances are very low that the average prosthetic clinic has ever had to fit a shoulder level amputee — but we have. As the only prosthetic care center that focuses solely on upper limb differences, we have the skill set to take on the challenge of creating and fitting the devices required for the patient to have a functional arm. In the past six years, we have evaluated and fit over thirty patients with shoulder-level amputations.

Beyond our experience with past patients, another reason we are uniquely qualified to fit patients with shoulder level limb differences is our published research concerning prosthetic management of individuals with this amputation level, and implementation of that research in the form of the MicroFrame. The MicroFrame is an interface that, when applicable, allows for the prosthetic arm to fit more comfortably, allow for a better range of motion and give the user better control of a myoelectric device. Combined, all those benefits lead to longer wear times for patients, allowing them to get back to work and accomplish their goals.

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 myoeletric prosthesis and reduce phantom limb and nerve pain.

In addition, because we have helped people who have this level of limb difference, we can connect new amputees with our current patients who are part of our Peer Support Network.

If you or someone you know has a shoulder level 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 a shoulder amputation or 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 articles here:

• Effects of Traumatic Amputation on Partnerships: Patient Perspective
• Effects of an Amputation on Family Members
• Effects of an Amputation on Friends of the Patient
• Seven Reasons Arm Dynamics Centers Are Different from Other Prosthetic Care Providers
• The Lived Experience: Peer-to-Peer Support by Arm Dynamics Patients