Traumatic upper-limb amputation is a devastating event. The inadequacies of current prosthetic technologies, with their inherent bulk and heat retention, lack of sensory input, and limited dexterity, have been readily acknowledged by the O&P profession. However, comparing upper-limb prosthetic function against able-bodied function fails to provide the type of insight that might guide clinical decision making. Once traumatic amputation has occurred, able-bodied function is no longer an option. However, depending upon some variables, a few options may exist. In addition to revision amputation and prosthetic fitting, individuals may be candidates for either surgical reattachment or surgical transplantation. Recent years have seen the publication of several clinical reports and reviews addressing the relative function and psychological considerations associated with these three treatment options. This article reviews recent literature, beginning with a comparison between the prosthetic function experienced with an external prosthesis and that associated with hand transplantation, and concluding with observations comparing replantation with prosthetic rehabilitation.
