A narrative review: current upper limb prosthetic options and design.

Purpose: This review was conducted to provide an overview of current literature as it relates to upper limb difference, available componentry, and prosthetic options and design. Emerging technologies combined with an increased awareness of the limb difference community have contributed to recent advancements in upper extremity prosthetics.Methods: A search of five major clinical databases utilizing keywords relating to upper limb prostheses, componenty and limb difference levels resulted in over 1200 articles. These articles were subjected to inclusion and exclusion criteria in order to identify current peer reviewed research relevant to this topic.Results: Fifty-five applicable articles and sources of standards were reviewed based on the inclusion and exclusion criteria, presenting five general options for prosthetic intervention. This information was assimilated and categorized in this article, which provides an overview of the aforementioned options.Conclusion: While a noteworthy amount of research focuses on technological advancements, the five options for prosthetic intervention are inherently represented in the current literature. For individuals with upper limb difference, as well as their care team, successful rehabilitation hinges on awareness of new components, the functional efficacy of these components, and the evolved techniques used in prosthetic design and fabrication. It is noted that the rapid evolution of upper limb prosthetics consistently outpaces research and publication of information.Implications for rehabilitationTo provide an overview of prosthetic design considerations and options to help create a more informed rehabilitation team, leading to improved outcomes in prescription and management of upper limb prosthetics.To bring awareness of current research in the field of upper limb prosthetics in order to provoke further exploration of the efficacy of prosthetic options and design considerations.

Upper extremity limb loss: functional restoration from prosthesis and targeted reinnervation to transplantation.

For several decades, prosthetic use was the only option to restore function after upper extremity amputation. Recent years have seen advances in the field of prosthetics. Such advances include prosthetic design and function, activity-specific devices, improved aesthetics, and adjunctive surgical procedures to improve both form and function. Targeted reinnervation is one exciting advance that allows for more facile and more intuitive function with prosthetics following proximal amputation. Another remarkable advance that holds great promise in nearly all fields of medicine is the transplantation of composite tissue, such as hand and face transplantation. Hand transplantation holds promise as the ultimate restorative procedure that can provide form, function, and sensation. However, this procedure still comes with a substantial cost in terms of the rehabilitation and toxic immunosuppression and should be limited to carefully selected patients who have failed prosthetic reconstruction. Hand transplantation and prosthetic reconstruction should not be viewed as competing options. Rather, they are two treatment options with different risk/benefit profiles and different indications and, hence vastly different implications.