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Below-Elbow Amputation

- See: Upper Extremity Prosthetics:

- Discussion:
    - below-elbow amputation is extremely functional, and successful prosthetic rehabilitation and sustained use are achieved in 70% to 80% of patients;
    - forearm rotation and strength are proportional to length retained;
- Long Below Elbow Stumps:
    - in long elbow stump w/ equal length of ulna & radius, larger radius might be kept 1-2 cm longer than ulna, but never the opposite;
    - in short stumps, the ulna might be somewhat longer than the radius;
- Short Below Elbow Amputation:
    - Congenital:
         - most common congential amputation;
         - radial head is always dislocated in congenitaal cases;
    - Traumatic:
         - in adult, even a short BEA stump 3.8 to 5 cm is preferable to an amputation thru or above the elbow joint;
         - the shorter the stump, the better it is to be covered by muscles;
         - clearly the lever arm is diminished;
         - using a munster or a split socket w/ step up hinges, an excellent prosthetic fit can be obtained;
         - short below elbow stump is still useful as long as insertion of biceps remains intact;
               - it can be transposed more proximally to radial head, thus increasing contact surface of the stump to facilitate prosthetic fitting;
         - consider resection of distal biceps insertion, if the end of the stump is not distal to insertion of the biceps on the radius;
               - this improves prosthetic fit, & brachialis flexes OK

Impact of Prostheses on Function and Quality of Life for Children with Unilateral Congenital Below-the-Elbow Deficiency