Use of the DEKA Arm for amputees with brachial plexus injury: A case series

Abstract

ObjectivePatients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm.MethodsThis was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis. Subject 2, not a prosthesis user, had a subluxed shoulder. Both were trained in laboratory and participated in a trial of home use. Descriptive analyses of processes and outcomes were conducted.ResultsSubject 1 was fitted with the transhumeral configuration (HC) DEKA Arm using a compression release stabilized socket. He had 12 hours of prosthetic training and participated in all home study activities. Subject 1 had improved dexterity and prosthetic satisfaction with the DEKA Arm and reported better quality of life (QOL) at the end of participation. Subject 2 was fit with the shoulder configuration (SC) DEKA Arm using a modified X-frame socket. He had 30 hours of training and participated in 3 weeks of home activities. He reported less functional disability at the end of training as compared to baseline, but encountered personal problems and exacerbation of PTSD symptoms and withdrew from home use portion at 3 weeks. Both subjects reported functional benefits from use, and expressed a desire to receive a DEKA Arm in the future.DiscussionThis paper reported on two different strategies for prosthetic fitting and their outcomes. The advantages and limitations of each approach were discussed.ConclusionUse of both the HC and SC DEKA Arm for patients with TH amputation and brachial plexus injury was reported. Lessons learned may be instructive to clinicians considering prosthetic choices for future cases.

Quality of life, functioning and participation of adult patients with an amputation following complex regional pain syndrome I or brachial plexus injury: a scoping review protocol

“…Amputation can be considered a last resort treatment for these patients as well. 8 9 To our knowledge, no data regarding incidence of amputation in these patient categories are available.…”

Roles of preoperative and early postoperative electrodiagnosis in brachial plexus injury patients undergoing nerve transfer operations: retrospective feasibility study

“…Even with the various methods that are used to treat patients with BPI, including rehabilitation or a prosthesis, surgeries, such as nerve grafting and nerve transfer procedures, are the most effective and widely used treatments. 1,[5][6][7][8][9] Conventionally, after nerve exploration to evaluate the root stump, nerve repair with or without grafting is performed if the root is available, and nerve transfer is performed if a definite preganglionic lesion, such as root avulsion, is present. Recently, with the reported effectiveness of nerve transfer, there have been attempts to perform nerve transfer without exploration.…”