Upper Extremity Program

Upper extremity is a very unique and specialized area within the prosthetics field due to the very low incidence and very catastrophic nature of these injuries. Upper extremity prosthetic limbs require very innovative and very case-specific solutions. At POSI we will provide you with an education and overview of all options available. There are generally six upper extremity prosthetic limb options available; each will be elaborated on below.

In addition, POSI silicone restorations utilize the finest materials to create devices that are attractive, durable and low maintenance. Our “state of the art” fabrication and repair department provide expedited fittings and repair for every type of electric controlled prosthesis. Due to our high volume of upper extremity case management, the POSI process includes a unique “loaner” program that reduces the down time associated with repairs on more sophisticated components.


No Prosthesis

Some individuals choose not to wear a prosthetic limb. They find that they can perform all needed tasks without the assistance of a prosthesis. Many individuals with congenital anomalies are extremely functional without the use of a prosthesis. They generally use their lower extremities to assist with bi-manual activities. Some feel that since a prosthesis tends to cover the residual limb, there is a loss of normal tactile sensory feedback. Even though these considerations factor into wearing a prosthesis, many people benefit from some type of appropriate prosthetic management.

Passive Design Prosthetic Limbs

Some amputees do not need a dynamic or active prosthesis. For those in this group, we have a variety of passive prosthetic limb options. A passive prosthesis provides a restoration of body symmetry. The prosthesis tends to remove the conspicuous nature of an injury or limb loss. A prosthesis adds weight to the human torso, which balances out the spine for better alignment. It also offers protection to the residual limb. These types of prostheses can be designed very simply or can be dramatic life-like restorations. Many times these silicone cosmetic restorations are oblivious to the majority of the people who encounter them.

At POSI, we use only the finest materials to fabricate these silicone restorations. In casting, we often use the sound side to duplicate the design from the involved side. Details, right down to the fingerprints, are copied into the restoration. The prosthesis is painted and highlighted with you and the artist “in person” in order to assure a very close match in skin color and texture. We even include hair if desired. Some advantages to passive designs include: little or no harnessing for suspension, low maintenance, and durable materials. Disadvantages of passive prosthesis include: no active control of a terminal device and limitation of bi-manual activities. Generally speaking, passive silicone restorations used in partial hands is recognized to restore some limited functional capabilities.

Myo-electric / External Powered Prosthesis

This prosthetic limb design eliminates the need for a harness system to capture motion in order to control the terminal devices and elbow. Today, there are numerous methods and control mechanisms which relay information to the terminal device hand and elbow. Myo-electrics use surface electrodes to pick up signals from the remaining musculature in the residual limb. These signals are used to tell the terminal device, wrist rotator or elbow to open or close or move up or down or rotate. If a muscle test shows not enough electrical input is available from a particular muscle group, we can use switches or touch pads to operate the componentry. Currently most newer technology uses some type of micro processor (tiny computer), which allows the prosthetist to customize and refine the signals for operation of the prosthesis.

Externally powered prostheses use batteries to power the motors at the terminal device, wrist and elbow. The technology in batteries has improved so much that we now use lithium ion and nickel metal hydride batteries in many of our designs. These high-tech batteries allow the prosthesis to be used for up to three days between charges. Advantages for externally powered prostheses are an increase in grip force available at the hand and the elimination or reduction of a harness surrounding the unaffected side. It also allows for a larger area or scope of function around the body. Disadvantages of powered prostheses include cost, weight, rough duty, and unclean environments. Today with the advent of new processors and the eliminated of hard wiring as in previous designs, powered prostheses are now considered quite dependable and durable. Additionally, with the new silicone technology available , the cosmetic look of the prosthesis can be matched to resemble the sound side very closely. Since there is a host of options for terminal devices, wrists, elbows and control mechanisms, we are careful to select only those agreed upon after the amputee has been educated on all of their options.

Activity Specific Prosthetic Limbs

Activity prostheses encompass any specific activities or needs that have not been addressed through the previously mentioned options. They may include a particular hobby or interest such as fishing, swimming, golf, billiards, photography, etc. They can be vocation specific, such as construction, crane operator, drummer, or machine operator. Any task one can think of can usually have a specific prosthesis design that will assist with the operation of one’s particular needs. Many times these designs are very unique to the individual’s needs and their personality.

The above types of prostheses are only a brief overview of the options available today and should not be considered all-inclusive. If you have any specific questions regarding these Upper Extremity options, please click on Contact and we will be glad to respond by email within 24 hours.