Unlike our lower limbs,which are primarily a means of mobility, our upper limbs serve many functions: fine and gross motor skills, providing information to our senses, promoting social connection through touch, and conveying our emotions through gesture. In fact, a significant portion of the human brain’s makeup is dedicated to the control of our hands. Thus, for this issue we assembled several perspectives on the multifaceted challenge of prosthetic care for the upper limb, care that is significantly distinct from that of the lower limb that most practitioners are more familiar with.
Our cover story, “Perspectives on 3D Printing and Fake News,” takes on the way in which media sources can oversimplify upper-limb prosthetic care in their reporting about open-source, 3D-printed prosthetic designs. These reports generally misrepresent the functional limitations and may portray the devices as superior to traditional prostheses. But rather than viewing such reports as intentionally misleading, this article offers tips about how the profession can help educate journalists and respond to the stories by continuing to build trust with patients and referral sources and increase expertise with 3D-printing technology.
“Cognitive Engagement of the Prosthetic Hand” explores the intricate connection between the brain and the hand and how that relationship impacts upper-limb loss and prosthetic care. Because of the myriad functions the hand performs, the goal of upper-limb prosthetic care is not only to provide a functional device, but for the person to be able to cognitively integrate that device with his or her body.
Finally, “An Algorithm Proposal for Upper Limb Prosthetic Continuum of Care” provides history on the recent developments in upper-limb prostheses and establishes that there are distinct differences in the techniques necessary for successful lower-limb fittings and those needed for upper-limb fitting and care. While consulting an upper-limb specialist is advisable, this article also provides a sample checklist and memorandum of understanding that prosthetists in general practice can use to facilitate successful upper-limb fittings and delivery on a local level without burdening patients with the hardship of travel to one of the major regional upper-limb specialty clinics.
I hope you enjoy this issue devoted to helping patients to regain function and identity of one of the most complex human features, the hand.