Losing all or part of an arm is a major life event. Our arms/hands are used to help us interpret and engage with the world around us, and limb loss forces us to reevaluate how we navigate the world. But this is not something you need to go through alone.
This guide serves as a gateway to various resources to help with both pre-surgery preparation and post-surgery recovery for transradial, transhumeral or disarticulation-level amputation. For answers to questions not covered here, feel free to contact our information specialists. They will provide you with free personalized support and resources tailored to your specific situation.
For a guide specific to partial-hand or finger amputation, click here.
Surgery Preparation and Recovery
It is important that the patient is armed with knowledge and prepared both physically and emotionally for their amputation. With a dedicated care team and the right supports, the patient will be able to quickly recover from the procedure and learn to get back to living their life.
The patient and family will ideally consult with each member of the surgical and rehabilitation team. This team will fully explore the surgical process with the patient, and also explain how rehabilitation will work post-surgery.
You will also need to choose a prosthetist. You will be working a lot with this individual over the first year after your surgery (and ideally forming a long-term relationship with them beyond that), so it makes sense to choose someone you are comfortable with. You can visit our ProsthetistFinder to seek out a professional who meets your needs.
It may also help to speak with another amputee before the procedure to put your mind at ease. Amputee Coalition is connected with thousands of Certified Peer Visitors across the United States. We will connect you with someone who has gone through amputation to help guide you through both preparation and the road to recovery.
If this surgery is for a child, read our guide on limb differences in children for special considerations.
No two people’s amputation journeys will be the same, and the type of amputation procedure and rehabilitation process will be dependant on many different factors. The surgical team will explain the options for limb preservation, as well as the expected biomechanical outcome for prosthetic use after surgery. The goal of the procedure is to optimize for overall post-surgery function.
Doctors use various objective and subjective scoring models to determine how much of the arm to amputate. Factors they consider include:
- Amount of remaining biological arm available for leverage
- Retaining sensation and proprioception (perception of arm in physical space)
- Overall stability, movement and muscle strength
- Ability to carry
- Potential peripheral nerve damage related to trauma or amputation procedure
- Potential for infection
- Potential posture or back pain issues
- Potential for bone spurs
- Ease of incorporating prosthetic componentry
- Cosmetic considerations
No matter what level of amputation you undergo, you can take advantage of prosthetic devices to help resume day-to-day activities.
Recovery and Rehabilitation
The first day after surgery can be one of the most difficult. What was previously just an idea is now a reality. It is important to remember, however, that big changes also present new beginnings and opportunities
Your limb will be treated with special compression bandages or compression socks to help heal the wound quickly. This will also help prepare your residual limb for a prosthesis. The team will also advise you on how to wash and take care of your residual limb.
Your rehab team will likely include doctors, physical and occupational therapists, nurses, and a prosthetist. Rehab will begin shortly after the surgery to work on stretching and strengthening the remaining muscles of the arm. Overall your rehab could take anywhere from a few weeks to a few months.
When your residual limb is healed it will be cast using plaster or 3D imaging to create a test socket for a prosthesis. During rehab, you will be assigned a temporary prosthesis and the prosthetist will assess you during exercises to determine if the socket needs to be readjusted. Over the course of your rehab, you will also be discussing your prosthetic options as well as functional goals for prosthesis use.
Exercises performed with a temporary prosthesis include:
- Increasing/maintaining the range of motion in joints
- How to put on and take off your prosthesis
- How to control functions of your prosthesis
- Using prosthetic in conjunction with remaining limbs for day-to-day activities
When the swelling in your residual limb has fully subsided and you are entering the last phase of your rehab, you can start to wear a permanent prosthetic.
The road to recovery may also include navigating phantom pain, which you can learn more about here.
It is normal to go through some level of depression while you work through the massive changes that come with losing a limb. You may or may not be assigned a counselor as a part of your rehabilitation team to help you work through these difficult emotions. It is important that you recognize the signs of depression, and remember that others have gone through many of these same feelings. If you need help, don’t be afraid to ask for it.
For more information be sure to read our guide on how to cope with the loss of a limb.
Prosthetics Guide For Arm Amputees
There are a multitude of prosthetic arm options available, and many amputees have multiple prosthetics for use on different occasions.
A passive prosthesis is designed to resemble a biological arm or hand, and can be made extremely lifelike using painted silicone. Often your other arm is often used as a model for the construction of a passive prosthesis.
Passive prostheses don’t have active movement components, but are sturdy and can aid in activities such as opening a cupboard or carrying an object. Some passive prostheses varieties are available that include a multi-positional shoulder, elbow or wrist joint to adjust in different circumstances.
A three-harness cable system prosthesis that allows the wearer to grasp objects, flex and lock the elbow. There are two varieties of body-powered prostheses that offer different hand functions:
- Voluntary Open: opens the hand when applying tension to the cable
- Voluntary Close: closes the hand when applying tension to the cable
Hand options for this type range from basic hooks to realistic painted silicone models.
Electrically Powered (Myoelectric)
An electrically powered prosthesis that resembles and closely mimics the function of a biological arm. The user controls it with electrical impulses through muscles in the residual limb. This option is more expensive than a body-powered prosthesis and it needs frequent recharging. It also requires a great deal of fine-tuning to get the prosthesis to interpret the electrical signals, and may not work for all people.
A combination of both body-powered and electrical components. This type of prosthesis is generally used for above the elbow amputations. It’s specialized to enable a greater range of motion and function for the wearer.
Limbs designed for specific tasks such as work, sports, or hobbies. For example, you might have a limb made to allow you to use specific tools at work, or a prosthetic arm designed to help you make waves at the pool.
While not yet widely available to the public, neuroprosthetics are a new wave of experimental computerized-prosthetics directly controlled by the human brain. These technologies are similar to the myoelectric prosthetics mentioned above, but use more complex electrodes (usually embedded into the limb and/or brain) and sensors to interpret and also send signals between the prosthetic and the brain.
People who have been trialing neuroprosthetics have been able to perform intricate tasks such as carrying an egg, and even experience touch and pressure sensations from sensors in the limb.
For more information, read our related post: Neuroprosthetic Limbs: Exploring the Future of Prosthetics
Some amputees who struggle with wearing socket prosthetics may choose to undergo a procedure known as osseointegration. This surgical procedure grafts a metal bar directly to the bone in your residual limb that extends out of the skin. A prosthetic can then be attached to that piece of metal – providing additional stability and ease of use to the wearer.
Learn more about osseointegration here. (EDITOR NOTE: Link to August post on osseointegration)
Resuming an Active Lifestyle After Amputation
As you recover from your amputation, you should be able to resume your day-to-day activities. While there will be an adjustment period, you will soon be able to do most everything you could prior to amputation.
Exercise and Sports
Modern prosthetics have made it possible for amputees to live active lives, and even compete against able-bodied athletes. There are also dozens of adaptive sports and equipment available for people of all abilities.
Driving a Car
You can still drive a car even if you’ve had some level of amputation on one or both arms. Steering wheel or foot-steering modifications are available for various car models that allow you to maintain your independence and get where you need to go.
Learn more about how to drive with various levels of amputation here.
Perhaps one of the hardest challenges to navigate after amputation is socializing with friends, family, and others. You may perceive that you are helpless, or that you are being treated differently because of your injury as people fixate on it.
To help process your feelings you may want to access one of our 400 registered Limb Loss Support Groups. These groups allow you to express your feelings amongst other amputees and can help provide you with the tools to help navigate these new social situations.
Request More Resources on Amputation
We hope this guide has provided you with the knowledge you need to get through this challenging time. You likely still have many questions.
Be sure to check out our resources section for more information on various topics:
At Amputee Coalition, our mission is to make sure that no one going through limb loss feels alone. Along with our peer visitor program, we offer plenty of services and support for those who will soon be undergoing amputation or already have.
For free, personalized resources and information about how to access all of our services, reach out to one of our dedicated information specialists.
Featured Photo Credit: Albert Gea For Reuters via Insiders.