Fitting Above-Elbow Amputees with Externally Powered Prostheses

FRANK J. TROST, MD*Minneapolis, Minnesota

Twenty-four children, aged 4 1/2 to 13 years, with above-elbow or higher amputation were fitted with externally powered prostheses and followed for an average of 3.7 years. The group included 17 congenital amputees; 16 children had unilateral amputation. Various electric elbows and externally powered terminal devices were used, the most common combination being an electric elbow with a body-powered hand or hook, Several types of switches and myoelectric controls were included. Half of the children still use their externally powered prostheses functionally. Elbow repairs were the most common cause of downtime, frequently for protracted periods.

Advantages of externally powered prostheses include ease of operation, good appearance, increased function, and greater power for very high level amputees. Disadvantages are frequent repairs, extended loss of prosthetic use while it is being repaired, excessive weight, lack of durability, noise, and lack of proprioception. Higher level amputees seemed to have a high rejection rate, as did vigorous prosthetic users. Because of the great cost of externally powered components, selection is most important. Patient selection and prescription criteria are still not well defined.

*Shriners Hospital for Crippled Children, 2025 East River Road, Minneapolis, MN 55414