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Review
. 2019 Jun;143(6):1688-1701.
doi: 10.1097/PRS.0000000000005638.

Prosthetic Rehabilitation and Vascularized Composite Allotransplantation following Upper Limb Loss

Carrie A Kubiak  1 , Joanna W Etra  1 , Gerald Brandacher  1 , Stephen W P Kemp  1 , Theodore A Kung  1 , W P Andrew Lee  1 , Paul S Cederna  1
Affiliations
Review

Prosthetic Rehabilitation and Vascularized Composite Allotransplantation following Upper Limb Loss

Carrie A Kubiak et al. Plast Reconstr Surg. 2019 Jun.

Abstract

Background: Upper limb loss is a devastating condition with dramatic physical, psychological, financial, and social consequences. Improvements in the fields of prosthetics and vascularized composite allotransplantation have opened exciting new frontiers for treatment and rehabilitation following upper limb loss. Each modality offers a unique set of advantages and limitations with regard to the restoration of hand function following amputation.

Methods: Presented in this article is a discussion outlining the complex considerations and decisions encountered when determining patient appropriateness for either prosthetic rehabilitation or vascularized composite allotransplantation following upper limb loss. In this review, the authors examine how psychosocial factors, nature of injury, rehabilitation course, functional outcomes, and risks and benefits may affect overall patient selection for either rehabilitative approach.

Results: This review summarizes the current state of the literature. Advancements in both prosthetic and biological strategies demonstrate promise with regard to facilitating rehabilitation following upper limb loss. However, there remains a dearth of research directly comparing outcomes in prosthetic rehabilitation to that following upper extremity transplantation.

Conclusions: Few studies have performed a direct comparison between patients undergoing vascularized composite allotransplantation and those undergoing prosthetic rehabilitation. Upper extremity transplantation and prosthetic reconstruction should not be viewed as competing options, but rather as two treatment modalities with different risk-to-benefit profiles and indications.

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References

    1. Hargrove LJ, Miller LA, Turner K, Kuiken TA. Myoelectric pattern recognition outperforms direct control for transhumeral amputees with targeted muscle reinnervation: A randomized clinical trial. Sci Rep. 2017;7:13840.
    1. Baumgartner RF. Upper extremity amputation and prosthetics. J Rehabil Res Dev. 2001;38:vii–vix.
    1. Ham R, Cotton L. Limb Amputation. 1991.Boston, Mass: Springer US.
    1. Demet K, Martinet N, Guillemin F, Paysant J, André JM. Health related quality of life and related factors in 539 persons with amputation of upper and lower limb. Disabil Rehabil. 2003;25:480–486.
    1. Jones LE, Davidson JH. The long-term outcome of upper limb amputees treated at a rehabilitation centre in Sydney, Australia. Disabil Rehabil. 1995;17:437–442.

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