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PLoS One. 2017 Jun 19;12(6):e0178642. doi: 10.1371/journal.pone.0178642. eCollection 2017.

Use of the DEKA Arm for amputees with brachial plexus injury: A case series.

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Providence VA Medical Center, Providence, RI, United States of America.
Health Services, Policy and Practice, Brown University, Providence, RI, United States of America.
Amputation System of Care-Northeastern Region, United States Department of Veterans Affairs, James J. Peters VA Medical Center, Bronx, NY, United States of America.
Southeast Regional Amputation Center, Tampa, FL, United States of America.
University of South Florida, College of Medicine, Department of Neurology, Division of PM&R, Tampa FL, United States of America.
HSR&D/RR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), Tampa, FL, United States of America.
VA New York Harbor Healthcare System, New York, New York, United States of America.
Rehabilitation Medicine, New York University School of Medicine /Rusk Institute, New York, New York, United States of America.



Patients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm.


This was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis. Subject 2, not a prosthesis user, had a subluxed shoulder. Both were trained in laboratory and participated in a trial of home use. Descriptive analyses of processes and outcomes were conducted.


Subject 1 was fitted with the transhumeral configuration (HC) DEKA Arm using a compression release stabilized socket. He had 12 hours of prosthetic training and participated in all home study activities. Subject 1 had improved dexterity and prosthetic satisfaction with the DEKA Arm and reported better quality of life (QOL) at the end of participation. Subject 2 was fit with the shoulder configuration (SC) DEKA Arm using a modified X-frame socket. He had 30 hours of training and participated in 3 weeks of home activities. He reported less functional disability at the end of training as compared to baseline, but encountered personal problems and exacerbation of PTSD symptoms and withdrew from home use portion at 3 weeks. Both subjects reported functional benefits from use, and expressed a desire to receive a DEKA Arm in the future.


This paper reported on two different strategies for prosthetic fitting and their outcomes. The advantages and limitations of each approach were discussed.


Use of both the HC and SC DEKA Arm for patients with TH amputation and brachial plexus injury was reported. Lessons learned may be instructive to clinicians considering prosthetic choices for future cases.

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