Prosthetic Rehabilitation and Vascularized Composite Allotransplantation following Upper Limb Loss

Carrie A. Kubiak, Joanna W. Etra, Gerald Brandacher, Stephen W.P. Kemp, Theodore A. Kung, W. P.Andrew Lee, Paul S. Cederna

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Upper limb loss is a devastating condition with dramatic physical, psychological, financial, and social consequences. Improvements in the fields of prosthetics and vascularized composite allotransplantation have opened exciting new frontiers for treatment and rehabilitation following upper limb loss. Each modality offers a unique set of advantages and limitations with regard to the restoration of hand function following amputation. METHODS: Presented in this article is a discussion outlining the complex considerations and decisions encountered when determining patient appropriateness for either prosthetic rehabilitation or vascularized composite allotransplantation following upper limb loss. In this review, the authors examine how psychosocial factors, nature of injury, rehabilitation course, functional outcomes, and risks and benefits may affect overall patient selection for either rehabilitative approach. RESULTS: This review summarizes the current state of the literature. Advancements in both prosthetic and biological strategies demonstrate promise with regard to facilitating rehabilitation following upper limb loss. However, there remains a dearth of research directly comparing outcomes in prosthetic rehabilitation to that following upper extremity transplantation. CONCLUSIONS: Few studies have performed a direct comparison between patients undergoing vascularized composite allotransplantation and those undergoing prosthetic rehabilitation. Upper extremity transplantation and prosthetic reconstruction should not be viewed as competing options, but rather as two treatment modalities with different risk-to-benefit profiles and indications.

Original languageEnglish (US)
Pages (from-to)1688-1701
Number of pages14
JournalPlastic and reconstructive surgery
Volume143
Issue number6
DOIs
StatePublished - Jun 1 2019

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Vascularized Composite Allotransplantation
Upper Extremity
Rehabilitation
Transplantation
Psychology
Amputation
Patient Selection
Hand
Wounds and Injuries
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Prosthetic Rehabilitation and Vascularized Composite Allotransplantation following Upper Limb Loss. / Kubiak, Carrie A.; Etra, Joanna W.; Brandacher, Gerald; Kemp, Stephen W.P.; Kung, Theodore A.; Lee, W. P.Andrew; Cederna, Paul S.

In: Plastic and reconstructive surgery, Vol. 143, No. 6, 01.06.2019, p. 1688-1701.

Research output: Contribution to journalArticle

Kubiak, Carrie A. ; Etra, Joanna W. ; Brandacher, Gerald ; Kemp, Stephen W.P. ; Kung, Theodore A. ; Lee, W. P.Andrew ; Cederna, Paul S. / Prosthetic Rehabilitation and Vascularized Composite Allotransplantation following Upper Limb Loss. In: Plastic and reconstructive surgery. 2019 ; Vol. 143, No. 6. pp. 1688-1701.
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