Angulation Osteotomy to Improve Function in Transhumeral Amputee Rehabilitation

Regardless of prosthetic design, there exist inherent limitations which adversely affect the functionality of transhumeral prostheses. Loss of voluntary humeral rotational control, limitations in prosthetic suspension and decreased range of motion limit the user’s acceptance and functional use of a prosthesis. Various techniques have been discussed in the medical literature to compensate for these shortcomings. These include socket design techniques, harness techniques, and surgical techniques. Marquette introduced the concept of humeral angulation osteotomy to resolve these issues. By surgically angling the distal humerus the amputee can be fit with a self-suspending prosthesis that enables voluntary rotational control without restrictions to range of motion. Although this technique is discussed in various prosthetic text books, very few cases have been reported. Case studies will be presented showing surgical, rehabilitation, and prosthetic considerations.