Types of Upper Extremity Prostheses


passivecosmeticA passive cosmetic prosthesis restores the cosmetic appearance, but does not have any actively moving parts.  Passive devices can appear remarkably life-like and often match the skin tone and contours of your natural limb. These devices are the lightest and most simple type of upper extremity prosthesis and can be pre-positioned in specific positions to hold light objects. Many amputees may choose a passive cosmetic prosthesis to restore the cosmetic appearance of the hand.

BodyPoweredProsthesisA body-powered prosthesis uses body movements to operate flexing of the elbow  (transhumeral and higher amputation levels only) and opening and closing of a terminal device (hook or hand). A harness, worn around the opposite shoulder, much like a backpack strap, is connected to a cable, elbow (if transhumeral or higher amputation level) and terminal device. When certain movements are performed, such as shoulder flexion (raising your arm in front of you), tension is placed on the cable and the terminal device is opened. When relaxed, the terminal device closed. Lightweight, simple and cost effective, body powered prostheses are excellent options for very active individuals requiring maximum durability.

Identify.Transradial.Harness
Harness for a transradial body powered prosthesis. When tension is placed on the cable through specific body movements, the terminal device opens/closes

ADVANTAGES


More Durable
Less maintenance than external powered devices
Lighter than external powered devices
No daily charging
Safe for use around water or dusty environments
Less expensive

DISADVANTAGES


Harnessing can be somewhat restrictive
Not as intuitive to use
Less cosmetic

iLimbUltraAn externally powered or myoelectric prosthesis, is a battery powered device using muscle signals from the user to open and close a terminal device. Surface electrodes or pressure sensors are placed above remaining muscles on the arm pick up muscle movement and transmit a signal to an electrical terminal device. Intuitive and life-like, myoelectric prostheses represent the greatest advancements in upper extremity prosthetics. The parameters of the hand control are adjusted using a laptop or tablet by the prosthetist.


Electrodes

Incorporated into the socket, electrodes receive muscle movement signals and transmit them to the terminal device.

OB.electrodes
An up close view of one type of electrodes used for inside a myoelectric prosthesis.
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Dan Luitjohan, CP, working with a patient to optimize the use of her transradial myoelectric prosthesis

ADVANTAGES


Less harnessing, less restricted movement
Intuitive to use
More cosmetic
Greater range of motion

DISADVANTAGES


Less durable
More maintenance required
Heavier than body powered
Must keep out of wet, dusty environments
Daily battery charging
Expensive
Extensive training / therapy required

Most commonly used for transhumeral and higher levels of amputation, the hybrid prosthesis combines both body and external power. For example, a hybrid prosthesis may combine externally powered elbow with a body powered hand.

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