Upper-limb prostheses

Upper-limb prostheses for above-/below-elbow amputation, thumb and finger amputation

Osseointegrated Prostheses for the Rehabilitation of Amputees, the OPRA method, enhance quality of life and offer a greater degree of freedom in everyday life.

Problems with socket-suspended prostheses

The majority of people who use prostheses have reported a range of problems and difficulties with the prosthetic socket.

By surgically implanting a titanium screw into the residual bone, the prosthesis can instead be attached without using a socket. The prosthesis always fits, always attaches correctly and is always held firmly in place.

Osseointegrated Prostheses for the Rehabilitation of Amputees, OPRA, enhance quality of life and offer a greater degree of freedom in everyday life.

Advantages

• Stable attachment

  A bone-anchored prosthesis is attached without using a socket, thereby ensuring stability. Another benefit is that it only takes a few seconds to attach the prosthesis.

• Reduced discomfort

  A bone-anchored prosthesis eliminates discomfort, such as heat, sweating and chafing.

• Osseoperception

  The patients experience improved sensory feedback because of the phenomenon of sensation through the bone, i.e. osseoperception.

• Thumb amputation

  There is no good prosthetic solution for traditional fitting in connection with thumb amputation, but osseointegration is currently the best cosmetic option. Other alternatives are toe-to-finger transfer or the surgical creation of a thumb using the index finger.

Implant surgery

The treatment consists of two operations with a three- to four-month interval. In the first operation, a specially constructed titanium screw (fixture) is installed in the residual bone. The period of hospitalisation is usually about two to four days.

In the second operation, an abutment is added to the fixture. The abutment protrudes through the skin. The period of hospitalisation is approximately two to four days and you will only be able to undertake limited exercise according to your training programme in the following weeks, thereby allowing the skin to heal.

Rehabilitation

When it comes to above-elbow amputation, loading of the bone can start (using a short training prosthesis) after the skin penetration area has healed, which is approximately three to six weeks after the second operation.

Everyday exercise is based on your imposing a load on the prosthesis on a standard set of scales. By gradually increasing the load, the strength of the bone will improve. Approximately twelve weeks after the second operation, a prosthesis can be fitted. In the case of below-elbow and thumb amputees, the movement of adjacent joints is exercised until the prosthesis is fitted.

There is normally a four- to six-month interval between stages one and two for transhumeral and transradial patients and four months for thumb patients. In a few selected cases, where there is good bone quality, stages one and two have been performed simultaneously.

When it comes to transhumeral patients, a short training prosthesis is used three to six weeks after stage two, with increasing weights and loading until the patient reaches the weight of the final prosthesis. It could be a myo-electric, body-powered or cosmetic prosthesis.  No short training prosthesis is used for transradial or thumb patients.

The team at the Department for Prosthetics and Orthotics at Sahlgrenska University Hospital will provide the prostheses, as well as instructions for training. Everyday training continues at home.

Recovery and check-ups

If no complications occur, osseointegration will normally be satisfactory one year after the first operation takes place. Please note that, once treatment is completed, regular medical check-ups will still be performed at Sahlgrenska University Hospital. In addition to the check-ups, the Department of Prosthetics and Orthotics at Sahlgrenska University Hospital also examines the actual prosthesis. As with all types of surgical treatment, there is a risk of complications that may change the treatment or lead to a less satisfactory result.

Do you want more information? Please do not hesitate to contact us.