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UPPER-EXTREMITY AMPUTATIONS AND PROSTHESES
Francis M. McKeever
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Perry Jones General Hospital Battle Creek, Michigan
1944 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1944; 26:660-706 
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Abstract

1. The economic displacement of an individual with a major amputation of the upper extremity is much greater than of one with an amputation of the lower extremity.

2. Prostheses for the upper extremity are less satisfactory than those for the lower extremity.

3. The open circular amputation should he used for any potentially infected amputation of the upper extremity.

4. Arm stumps from the level of the pectoral insertion to the shoulder have no functional value.

5. The humeral stump of choice is one just above the flare of the humeral condyles.

6. The forearm stump of choice is one at the junction of the middle and lower thirds of the forearm.

7. Disarticulation through the wrist produces a poor stump.

8. Forearm stumps containing carpal bones and covered by palmar skin are satisfactory.

9. Artificial hands are of little value.

10. The most useful appliance for a prosthesis is the split hook. For repetitious work the Bowler hook is more useful.

11. The practical attitude to take toward an arm prosthesis is that it is "a tool-holding device".

12. Completely cosmetic hand restorations will not stand close scrutiny, and have absolutely no functional value.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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