Delivery of UK military upper limb prosthetics: current concepts and future directions
Abstract
Upper limb prosthetics have a challenging task. A natural upper limb combines strength, coordination and dexterity to accomplish daily activities such as eating, writing, working and social interaction. Artificially replicating these functions requires a prosthetic with composite, synchronous motor function while maintaining sensory feedback and skeletal stability. Achieving these functions requires interfaces between biology and machine across nerve, muscle, bone and skin. This leads to issues related to infection, foreign material encapsulation and implant stability, and electrical signal transduction and interpretation. Over the last 20 years the advent of technologies such as osseointegration, targeted muscle reinnervation, implantable myoelectric sensors, peripheral nerve interfaces and pattern recognition technology has sought to address these problems.Due to many advances in prehospital care, truncated timelines to damage control surgery and improved combat personal protective equipment, the numbers of amputees have increased with more patients surviving injury. From October 2001 to March 2019 there were 333 amputees from Afghanistan and Iraq compared with 457 fatalities over a similar period. Over a third of these were significant multiple amputees. With a functional, robust upper limb prosthetic which mirrors or exceeds normal function, injured service personnel could be returned to an active combat role. This has benefits for their physical and mental health, improves employability prospects and allows Defence to retain some of its most highly motivated and skilled people who represent significant financial investment.Citation
Thomas RL, Howes R, McMenemy L, Hindle P, Wordsworth M, Staruch R. Delivery of UK military upper limb prosthetics: current concepts and future directions. BMJ Mil Health. 2023 Oct 24:e002485. doi: 10.1136/military-2023-002485. Epub ahead of print.Type
ArticleAdditional Links
https://militaryhealth.bmj.comPMID
37879645Journal
BMJ Military HealthPublisher
BMJ Publishing Groupae974a485f413a2113503eed53cd6c53
10.1136/military-2023-002485