An amputee trials the Ottobock manufactured bebionic hand while accompanied by an O&P professional
Living with an arm amputation

Before the amputation

Information on the topic of arm amputations, including preparation, support and amputation levels.

Snapshot

Getting ready to lose a hand or arm

No matter why you need an amputation surgery, you’re preparing for a life-changing event. You may have known for a while that you may lose a hand or arm. You may have just found out. Either way, you have an enormous amount on your mind right now.

While you’re facing this difficult process, remember that you’re not going through it alone. Your care team will be there at every step to help you physically and mentally prepare – for the procedure, for your recovery, and for your new life as someone with an upper limb difference. 

Here are a few of the topics they’ll discuss with you, and that you’ll learn about in this article: 

  • The different kinds of hand and arm amputations (“amputation levels”), and what to know about the kind you’ll experience

  • Important ways to start preparing for your amputation surgery, and how it will impact your everyday life

  • How and where to find support for your daily life with an upper limb difference

Reasons for amputation

Common reasons people lose an upper limb

Amputation – removing a limb from the body – can be necessary for a number of different reasons. Your doctor or surgeon may have told you that you need one because of an injury, a medical condition in your hand or arm, or because of a bigger health issue that’s affecting your limb.  

Your doctor or surgeon will usually decide you need an amputation surgery when they find a problem with your hand or arm that isn’t likely to heal, or that may put you at risk if the limb isn’t removed. Some common causes are:

  • Injuries your body can’t repair (like from a major accident)

  • Conditions like diabetes that can keep wounds from healing

  • Conditions like PAD that can block blood flow to your limbs

  • Certain cancers that grow in muscle or bone

  • Bloodstream infections that damage your limb

Types of amputation

Different “amputation levels” your procedure may involve

Just as there are many reasons your arm or hand may need to be removed, there are different forms of amputation surgery that your care team may plan for you.

Before your procedure they’ll consider a number of factors that determine the best “amputation level,” which simply means where and how your limb will be removed. Some of those considerations can include: 

  • Where your limb has been damaged

  • The source or cause of that damage

  • How much of your remaining arm (or “residual limb”) can be saved

  • The location that will heal most quickly and safely

Your amputation level can also be an important factor in which prosthetic devices will be most valuable and practical for you. During the planning process, you and your care team may talk to a professional prosthetist who can help find the right device for you based on your amputation, lifestyle, and favorite activities.

Here the different levels your care team may select, and some typical prosthetic options for each one:

Amputation level

The appropriate amputation level is established

The term amputation level describes the place where a body part is amputated. In addition to other factors, the amputation level determines the suitable prosthesis in each case.

The amputation level is established by the doctor before the operation and is based on the reason for amputating. In the case of planned interventions, an O&P professional is usually consulted as well in order to establish what amputation level is the most favourable for the subsequent treatment with a prosthesis.

Hand/finger amputation

Hand/finger amputation

This amputation level involves the removal of any portion of your hand above the wrist. That may include one or more fingers or your entire hand. A hand/finger amputation typically leaves your wrist joint intact. 

Prosthetics to plan for:

  • Finger and/or partial hand prostheses 

  • Custom cosmetic solutions to restore your hand’s natural appearance

An illustration of the human skeleton. The left hand is missing fingers to demonstrate hand/finger amputation.
Wrist disarticulation

Wrist disarticulation

In this procedure your hand is removed at the wrist joint, which can no longer move or rotate. Most people who have a wrist disarticulation can still use a prosthetic that attaches to their forearm.

Prosthetics to plan for:

  • Prosthetic hands like the VariSpeed Plus, Michelangelo, or bebionic

  • A custom socket that connects the prosthesis to your residual limb

  • Connectors and adaptors for different components of your prosthetic

An illustration of the human skeleton. The left hand is missing to portray wrist disarticulation and a hand amputation
Transradial amputation

Transradial amputation

This form of amputation involves removing your hand and a portion of your forearm. Depending on your amputation surgery, your remaining forearm may be long, medium length, or short. It may also extend just below your elbow

Prosthetics to plan for: 

  • Prosthetic hands like the VariSpeed Plus, Michelangelo, or bebionic

  • A custom socket that connects the prosthesis to your residual limb

  • Connectors and adaptors for different components of your prosthetic

An illustration of the human skeleton. The left hand and partial arm are missing to portray a transradial amputation
Elbow disarticulation

Elbow disarticulation

With this form of amputation, your whole forearm will be removed at the elbow joint. This amputation saves your upper arm, but your elbow will no longer be able to move or rotate.

Prosthetics to plan for:

  • Prosthetic hands like the VariSpeed Plus, Michelangelo, or bebionic

  • A prosthetic elbow joint like DynamicArm

  • A custom socket that connects the prosthetics to your residual limb

  • Connectors and adaptors for different components of your prosthetic

An illustration of the human skeleton. The left forearm and hand are missing to portray an elbow disarticulation
Transhumeral amputation

Transhumeral amputation

This form of amputation involves removing your arm midway through the upper bone called the “humerus.” The remaining portion of your upper arm may be long, medium length, or short.

Prosthetics to plan for: 

  • Prosthetic hands like the VariSpeed Plus, Michelangelo, or bebionic

  • A prosthetic elbow joint like DynamicArm

  • A custom socket that connects the prosthetics to your residual limb

  • Connectors and adaptors for different components of your prosthetic

An illustration of the human skeleton. The left hand, forearm, and elbow are missing to portray a transhumeral amputation
Shoulder disarticulation

Shoulder disarticulation

This amputation level involves removing your entire arm from your shoulder joint. Depending on how your surgeon performs this procedure, some parts of your shoulder may be affected as well.

Prosthetics to plan for: 

  • Prosthetic hands like the VariSpeed Plus, Michelangelo, or bebionic

  • A prosthetic elbow joint like DynamicArm

  • A custom socket that connects the prosthetics to your shoulder

  • Connectors and adaptors for different components of your prosthetic

An illustration of the human skeleton. The left arm is missing to portray an arm amputation and shoulder disarticulation
Forequarter amputation

Forequarter amputation

Sometimes called an “interscapular-thoracic” amputation, this procedure removes your arm, shoulder joint, and shoulder blade, as well as part of your collar bone. 

Prosthetics to plan for: 

  • Prosthetic hands like the VariSpeed Plus, Michelangelo, or bebionic

  • A prosthetic elbow joint like DynamicArm

  • A custom socket that connects the prosthetics to your body

  • Connectors and adaptors for different components of your prosthetic

An illustration of the human skeleton. The entire left arm is missing, including the shoulder, to represent a forequarter amputation
How to prepare

What to expect before your amputation surgery

Removing a hand or arm is a major medical procedure, one your care team will plan and prepare you for as carefully as possible. Here are some of the key steps in that process, and some valuable ways to find the support you need as you get ready for your surgery.

(If you have an accident or sudden injury, you and your care team may not have time for all these steps. Many of them – like talking to other amputees and seeking mental health support – are still important to consider after your procedure.)

Pre-op consultations and exams

Once your doctor or surgeon decides you need an amputation surgery, they’ll give you a detailed explanation of: 

  • The kind of amputation you need and why

  • What the amputation process will involve

  • What your recovery process will be like 

Take notes and ask as many questions as you need to during these discussions. Your doctor or surgeon is there to help you understand the whole amputation process, how it will affect you, and how you need to prepare. 

If you’re having a scheduled amputation procedure, your care team will also conduct a set of thorough pre-op examinations. These exams will include blood tests, x-rays, and tests to check the the strength and stability of your heart and lungs.

Physical preparation

Before your procedure, your care team will also show you some important exercises you should start doing.

These physical activities can help you strengthen your muscles in ways that make your recovery easier and more successful. Your doctor or a physical therapist on your care team will explain which ones are most important for you to do. 

They may also have you speak to a professional prosthetist who can tell you which exercises will help you prepare for a prosthetic device. This specialized expert can help explain which devices may be best for you, and how to get ready to use one.

Mental preparation

When you’re getting ready for an amputation surgery, it’s important for you to prepare both physically and psychologically.

Take advantage of the time before your procedure to calm your mind and get yourself mentally ready for a life-changing event. 

There are a number of ways you can do so.

Talk to a mental health professional: Discussing your fears and concerns with a trained counselor can help you feel better prepared for your procedure. 

Visit a faith leader: If religion is important to you, speak to someone who can help you understand and accept how this major change will affect you. 

Use a mental health app: Several evidence-based options can help you manage and work through the daily stress of an upcoming procedure.

Don’t wait to get yourself mentally ready for this difficult process and new chapter in your life. The sooner you find the right support, the easier it will be to overcome the fear, doubt, and anxiety that naturally come with such a significant change – and the better prepared you’ll be for a successful recovery.

Connecting with other amputees

When you’re facing any life-changing event, there’s often no substitute for talking to other people who’ve been through the same experience.  

While you’re preparing for life with an upper lib difference – or already getting used to it – ask your care team to help connect you with the amputee community or support groups for people who share your medical condition. Talking to people who’ve been through what you’re facing can help you build the courage to succeed as well. 

There are a number of groups dedicated just to people with limb differences: 

Organizations like these can help connect you with support and resources in your area, introduce you to community advocates for people with limb difference, and help you start learning how to thrive with a prosthetic.