Tuesday, July 16, 2024

Bilateral above elbow challenges

Kinsey Herrin

Dear List,

I currently have a patient who has bilateral above elbow amputations. He is
an excellent candidate for body powered prostheses as he has his own
business caring for and selling orchids.
His left limb is long and cylindrical and amputated just above the elbow.
There is about 3/4″ between the distal end and where his anatomical elbow
joint should be. The right limb is actually bulbous on the distal end but
shorter so there is more room for a mechanical elbow. He was previously
right hand dominant.

I have several questions:

1. I am weighing the pros and cons of keeping the elbow centers at a normal
place and also maintaining humeral rotation. What strategies have worked
for your patients? Do you prefer to sacrifice the cosmetics for the
rotation?

2. What is the best way to help a bilateral patient with a bulbous limb don
prostheses independently? And what socket designs have you used
successfully?

3. If and when externally powered prostheses become an option, what elbow
joints do you like best and why?

Thanks for any feedback and I’ll be happy to re-post all replies.

Cheers,

Kinsey Herrin

*Kinsey Herrin, MSPO, CPO/LPO*
Certified/Licensed Prosthetist/Orthotist
Ortho Pro Associates, Inc.
(305) 598-9688

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