title: Osseointegration amputation prostheses on the upper limbs: methods, prosthetics and rehabilitation.
abstract: BACKGROUND
  The osseointegration programme for upper extremity amputation started in Sweden in 1990, when a titanium fixture was first implanted into a thumb. This method has since been used for transhumeral and below-elbow amputation. The treatment involves two surgical procedures. During the first a titanium fixture is surgically attached to the skeleton, and a second procedure six months later involves a skin penetrating abutment to which the prosthesis is attached.
  
  
  OBJECTIVE
  To describe the osseointegration procedure for surgery, prosthetics and rehabilitation.
  
  
  METHODS
  Patients with short stumps and previous problems with prosthetic fitting were selected. From 1990 to April 2010, 37 upper limb cases were treated and fitted with prosthesis: 10 thumbs, 1 partial hand, 10 transradial and 16 transhumeral amputations. Of these, 7 patients are currently not prosthetic users.
  
  
  RESULTS
  Patients indicated that function and quality of life had improved since osseointegration.
  
  
  CONCLUSIONS
  Osseointegration is an important platform for present and future prosthetic technology. The prosthetic situation is improved due to the stable fixation, freedom of motion and functionality.
  
  
  CONCLUSIONS
  The two-stage osseointegration procedure has the potential to change the rehabilitation strategy for selected upper limb amputees. The method eliminates the need for a socket and the prosthesis will always fit. The stable prosthetic fixation and increased freedom of motion generates improved function. Specially designed components and rehabilitation procedures have been developed.
authors.affiliation: Department of Prosthetics & Orthotics, Centre of Orthopaedic Osseointegration, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Stewe
authors.initials: S
authors.lastname: Jönsson
authors.forename: Kerstin
authors.initials: K
authors.lastname: Caine-Winterberger
authors.forename: Rickard
authors.initials: R
authors.lastname: Brånemark
mesh_terms: D000293:Adolescent; D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs / Q000145:classification*; D005260:Female; D006225:Hand / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D019919:Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D011788:Quality of Life; D011884:Radius / Q000601:surgery; D012189:Retrospective Studies; D013548:Sweden; D013933:Thumb / Q000601:surgery; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium