Upper Extremity Anatomy, Kinesiology, and Function

This chapter covers the upper extremity restoration and rehabilitation and serves as a handy reference for busy practitioners to support sound clinical decision-making. It begins with basic anatomy, kinesiology, and a recap of surgical decisions principles and post-operative care for amputees. It discusses common medical issues such as phantom limb sensation and pain, skin problems, and sexual considerations. Wrist flexion-extension (FE) motions can be compensated by elbow FE, but radial-ulnar deviation (RUD) movements are less easily compensated. Forearm rotation is lost approximately in proportion to the length of the forearm removed. Arm rotation for above-elbow amputation becomes confined to that of the glenohumeral (GH) joint and is not affected by stump length. Prosthesis users compensate for lost distal motions by increasing the motion at other more proximal arm joints, including increased trunk displacement. Suspension requirements for the prosthesis can profoundly impact the residual biomechanics of the user.