Aesthetic Devices for the Arm

Most amputees are better able to handle a prosthetic device if it looks aesthetically pleasing to them.  This is why manufacturers go to great lengths to create an artificial arm that looks ad much like the real thing as possible.  The ideal prosthesis is one that can do as many activities as possible and that also looks like a real arm or hand.  Silicone is the preferred material for aesthetic hand and arm devices because it is durable and compatible with human tissue (less allergic potential).

Most people who have a prosthetic arm that is designed to look and behave like a real arm are able to use the entire arm and not just the hand at the end of the prosthesis.  They can do things like stabilizing a book on the prosthetic forearm and carry groceries by stabilizing the grocery bag with the hip and grabbing the bag with the arm and forearm.

Research has been shown on prosthetic devices that up to three-fourths of all users of aesthetic devices wear their device for at least 8 hours a day.  While the hand component is not perfect, it does provide the user with some usefulness as part of activities of daily living.  Having a realistic look to the prosthesis is important to the psychological growth and acceptance of the artificial limb.  Those that get used to the aesthetic device have later been known to be more accepting of devices that are more functional yet less aesthetically pleasing.

The “golden period” for getting a first prosthesis is about a month after sustaining an amputation.  After that, it is more difficult to get the patient to use the prosthesis on a regular basis.  While an aesthetically pleasing arm prosthesis can do things like pick up small objects, they tend to be better for large motor things, such as holding grocery bags or wrapping the arm around something.

The more aesthetically pleasing the device is, the greater is the chance that the patient will wear it.  It must be light-weight, easy to clean, and functional for as many activities as possible.  This can be a tall order for devices designed to be aesthetically pleasing.
 
Assessment of the Patient’s Needs
 
It must be decided exactly what the limb is be used for and whether there will be separate prostheses for “looks” and separate prostheses for “function”.  An ideal prosthesis will do both things.  In the beginning, a cast must be made of the residual limb so that a perfect fit can be maintained that at least partially attaches through suction to a close-fitting stump, with or without straps to help the prosthesis hold onto the body.
 
Fingers are the most type of upper extremity amputation, affecting 88 percent of all upper arm amputations.  Fortunately, these lend themselves well to aesthetically pleasing finger prostheses and most are held on by suction alone.  They tend not to need much in the way of fancy maneuvering and can be used in things like typing and writing.  Ideally, if many fingers have been cut off, a glove with the missing fingers is created so that all fingers can be attached using the same glove device.  Patients can have acrylic nails as part of their prosthesis.  These can be painted like regular nails, while silicone nails cannot be painted.
 
Glove-like prostheses are especially used when the thumb is missing and needs an artificial thumb.  This is because it needs to be able to firmly grasp things without dropping them.  Simply attaching a thumb using suction would be aesthetically-pleasing, but it could not do the job that a real thumb can do.

When a higher amputation has been sustained, a silicone arm can be made all in one piece.  It is a passive device, used more for looks than functionality.  The device can hide an elbow joint that can be put in a position of flexion by manipulating it with the opposite arm.  If the silicone goes all the way up to the axilla, the device doesn’t function as well at the elbow so some people simply have an aesthetically pleasing forearm and hand with a hidden elbow (hidden by clothing) that can bend and flex easily.
 
Arm prostheses can be really realistic, including arm hair and skin tones that nearly exactly match the patient’s good arm.  As mentioned, if the device has acrylic nails put in, the nails can be painted like regular fingernails.  If the person likes to suntan, he or she might need to have a silicone prostheses that is two different colors, depending on how much tanning the patient has done.

Having at least one prosthesis that can hide the amputation is important for the psychological welfare of the person who has had the amputation.  Some of these are completely passive, while others are coverings for more complex machinery that can be used myoelectrically or using body-powered motion. 
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