Myoelectric Prosthesis Success in Right Transradial Amputation: A Case Report

Case Diagnosis: Myoelectric- versus body-powered prosthesis function in a patient with spasticity and transradial amputation

Case Description or Program Description: The patient sustained a left cervical ICA dissection during a ski accident, resulting in right upper extremity hemiparesis, spasticity, and aphasia. Despite ongoing therapy and surgical interventions including tendon lengthening and neurectomies, a right transradial amputation was performed due to limited function with the right hand. Initial fitting with a body-powered prosthesis failed to meet his functional goals, prompting a transition to a myoelectric prosthesis after several months.

Setting: Outpatient amputee clinic and hand therapy

Assessment/Results: Upon transitioning to the myoelectric prosthesis, the patient exhibited substantial functional improvement, as evidenced by an increase in his Activities Measure for Upper Limb Amputees (AM-ULA) score from 12.7/40 with the body-powered prosthesis to 20/40 with the myoelectric device. His independence in daily and vocational activities improved, notably in opening containers, using tools, and completing office tasks.

Discussion (relevance): This case underscores the importance of individualized prosthetic selection in optimizing functional outcomes for patients with complex neurological and musculoskeletal impairments. The shift from a body-powered to a myoelectric prosthesis enhanced his independence, illustrating the impact of advanced prosthetic technology and tailored rehabilitation strategies on quality of life, particularly when conventional prosthetic options prove insufficient.

Conclusions: Myoelectric prosthetics may offer considerable functional advantages for patients with limited shoulder and scapular mobility due to spasticity. Continuous adjustments to prosthetic technology, alongside therapies such as botulinum toxin injections, are integral to optimizing rehabilitation outcomes. The patient’s active participation in managing his own care, including adjusting prosthetic settings, highlights the value of patient-centered care.