[Prosthetic reconstruction of the upper extremity].

BACKGROUND

Prosthetic replacement after amputation or loss of function of the upper extremity has gained therapeutic value over the last years. The control of upper arm prostheses has been refined by the use of selective nerve transfers, and the indication for prosthetic replacement has been expanded.

OBJECTIVES

Overview regarding surgical, therapeutic and prosthetic options in upper extremity amputations or their loss of function.

METHODS

Selective literature research including the authors' own experience in everyday clinical practice, as well as a review of medical records.

RESULTS

Selective nerve transfers of the amputated nerves of the brachial plexus to the remaining stump muscles can create up to six myosignals for intuitive and simultaneous control of the different prosthetic joints. This way, an efficient and harmonious control of the prosthetic device is possible without the need to change between the different control levels. The prosthetic replacement, with consequent elective amputation, represents a new approach in the functional reconstruction of the upper extremity, especially in patients with a functionless hand after massive soft tissue or nerve damage.