Management of Upper Limb Amputation Rehabilitation (ULA)

Publication Date: April 25, 2022

Last Updated: March 3, 2023

Objective

This patient summary means to discuss key recommendations from the Department of Veterans Affairs, the Department of Defense, for upper limb amputation. This patient summary is limited to adults 18 years of age and older and should not be used as a reference for children.

Overview

When part of an arm is damaged beyond repair by trauma, infection, or loss of blood supply it must be removed and replaced with a prosthetic.
There are multiple considerations regarding:
- the level of amputation
- the surgical technique
- preparing the remaining anatomy for a prosthesis
- training the amputee to use the prosthesis
- the patient’s physical and emotional needs during the process
- phantom limb pain
This patient summary finds insufficient evidence for making recommendations beyond what is listed below.

Treatment

The VA suggests:
- screening patients for cognition, mental health conditions such as posttraumatic stress disorder and depression, and pain during the initial evaluation and across the continuum of care
- the use of mirror therapy for the short-term reduction of phantom limb pain
- use of a body-powered or externally powered prosthesis to improve independence and reduce disability
- offering peer support services
Research is ongoing to identify and validate new treatments that will improve outcomes.

Abbreviations

ULA: Upper Limb Amputation
VA: Veterans Administration

Source Citation

Crunkhorn A, Andrews E, Fantini C, Highsmith MJ, Loftsgaarden M, Randolph B, Sall J, Webster J. The Management of Upper Limb Amputation Rehabilitation: Synopsis of the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for Acquired Amputation. Am J Phys Med Rehabil. 2022 Dec 8. doi: 10.1097/PHM.0000000000002164. Epub ahead of print. PMID: 36480336.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.