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Prosthet Orthot Int. 2011 Jun;35(2):190-200. doi: 10.1177/0309364611409003.

Osseointegration amputation prostheses on the upper limbs: methods, prosthetics and rehabilitation.

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1
Department of Prosthetics & Orthotics, Centre of Orthopaedic Osseointegration, Sahlgrenska University Hospital Gothenburg, Sweden.

Abstract

BACKGROUND:

The osseointegration programme for upper extremity amputation started in Sweden in 1990, when a titanium fixture was first implanted into a thumb. This method has since been used for transhumeral and below-elbow amputation. The treatment involves two surgical procedures. During the first a titanium fixture is surgically attached to the skeleton, and a second procedure six months later involves a skin penetrating abutment to which the prosthesis is attached.

OBJECTIVES:

To describe the osseointegration procedure for surgery, prosthetics and rehabilitation.

METHODS:

Patients with short stumps and previous problems with prosthetic fitting were selected. From 1990 to April 2010, 37 upper limb cases were treated and fitted with prosthesis: 10 thumbs, 1 partial hand, 10 transradial and 16 transhumeral amputations. Of these, 7 patients are currently not prosthetic users.

RESULTS:

Patients indicated that function and quality of life had improved since osseointegration.

CONCLUSION:

Osseointegration is an important platform for present and future prosthetic technology. The prosthetic situation is improved due to the stable fixation, freedom of motion and functionality.

CLINICAL RELEVANCE:

The two-stage osseointegration procedure has the potential to change the rehabilitation strategy for selected upper limb amputees. The method eliminates the need for a socket and the prosthesis will always fit. The stable prosthetic fixation and increased freedom of motion generates improved function. Specially designed components and rehabilitation procedures have been developed.

PMID:
21697201
DOI:
10.1177/0309364611409003
[Indexed for MEDLINE]
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