Updated November 28, 2014.

People who experience upper limb and hand amputations have many more options these days than there ever were in the past to use prosthetics as devices to help with function. This article will go through some of those devices and look at some of the upcoming things that may be possible in the future for people living with upper limb amputation. 

After upper limb amputation, many people will choose not to use a prosthetic at all.

Reasons for this may include that they are more functional without one, that a device tends to get in the way of their function, that they are not comfortable for the user, or that they are too heavy or difficult to use. It is important for anyone with an amputation to form a long lasting relationship with their care team, especially with their prosthetist, to ensure that many options can be tried prior to giving up on prosthetic devices. In the end, though, it is really each individual person's preference about whether or not they will use a device. 

Before we get started, there are some definitions that will be important when talking about prosthetics:

• Prosthetic: the device that attaches to a person in its entirety
• Socket: the part of the prosthetic that attaches to the person, usually custom molded for fit
• Terminal device: the end of the prosthetic that is the functional component. This could be a hand, hook, prehensor, or other type of functional tool

Prosthetic upper limbs can be split into many categories.

First, they can be separated into those that are used for cosmesis and those that are used for function. For cosmesis, the prosthesis usually attaches to a person's residual limb by way of a number of straps or a socket that has been molded to the person's body by the prosthetist. These devices usually are skin colored and end in a hand. They may not be useful for any type of function but can pass for a normal arm in social situations. 

Alternatively, there are prosthetics in which their primary use is functional. There are many options in this category. At the simplest level, body powered prosthetics use cable and pulley systems that are attached around a person's shoulder girdle in order to operate a terminal device such as a hook or prehensor. These devices are usually lightweight but require some skill to operate as they take motions like shoulder shrugging to move the terminal device. 

There are also prosthetics that fall into the electric category. Electric devices have sensors that lie over muscles that still work in a person's body usually closer to the shoulder than where the amputation is. These sensors pick up electric signals from the muscles when they contract and convert those signals to control the terminal device. These devices are usually a bit heavier and cost more, but they are capable of generating more force than a body powered device and require less strength to do so. 

Some up and coming devices in the prosthetic industry include ones that use enhanced technology to create finer motor movements like the Michelangelo Hand by Ottobock. There are also multiple research trials going on to try to find a terminal device that can have some sensation relayed back to the brain. One of the biggest challenges in upper limb prosthetics is finding a way to recreate the sensation lost when the hand was lost. Finding a way to involve the brain with the prosthetic is the next frontier of research in this important area of disability.