Above-elbow prosthesis
An upper limb prosthesis for cases without an elbow joint, consisting of an upper arm socket, prosthetic elbow joint, wrist and terminal device.
What is an above-elbow prosthesis?
An above-elbow prosthesis, clinically called a transhumeral prosthesis, is an upper limb prosthesis used when the amputation has taken place above the elbow joint, at the level of the upper arm. Since the person does not have their own elbow joint at this level, a prosthetic elbow joint takes on the elbow's task of bending and straightening.
An above-elbow prosthesis is an integrated system consisting of an upper arm socket that surrounds the residual limb, a prosthetic elbow joint, a wrist unit and a terminal device (hand or hook). Compared with below-elbow, planning and training become more prominent, both because the joint has to be recreated and because the number of movements to be controlled increases.
Arm amputation levels
The level at which the amputation takes place determines which natural joints are preserved and which components the prosthesis needs. The diagrams compare four different levels; they do not indicate measurements.
Below-elbow
The elbow joint is preserved; the hand and part of the forearm are missing. The prosthesis is planned with a socket fitted to the remaining forearm, a wrist unit and a prosthetic hand or hook.
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Above-elbow
The amputation is at the level of the upper arm; the natural elbow, forearm and hand are missing. In addition to the upper arm socket, the prosthetic system includes a prosthetic elbow, a wrist unit and a hand or hook.
Shoulder disarticulation
The arm is separated at the level of the shoulder joint; the upper arm, elbow, forearm and hand are missing. Prosthetic fitting is planned with a custom-made socket fitted to the shoulder area and components that take over the functions of the arm.
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Wrist amputation
In wrist disarticulation, the hand is separated at the wrist joint; the forearm and natural elbow are preserved. The prosthetic hand and connecting components are chosen according to the length of the preserved forearm and the person's needs.
Main components
The components are planned together as a whole; selection and adjustment are carried out under the guidance of the physician and the clinical team.
Upper arm socket
The custom-made part that grips the residual limb and the area around the shoulder, carries the prosthesis and provides control.
Prosthetic elbow joint
Takes on the elbow's bending and straightening function; can be locked and released mechanically or electronically.
Wrist unit
Allows the terminal device to rotate and be positioned.
Terminal device (hand / hook)
The end component that holds and grasps objects; it may be an electronic hand, a mechanical hand or a hook.
Control methods
In an above-elbow prosthesis, control of both the elbow and the terminal device is planned. Which method is suitable is determined by the specialist team according to muscle signals, the condition of the residual limb and the person's goals.
Myoelectric (electronic) system
An electronic approach in which both the prosthetic elbow and the hand can be controlled with muscle signals.
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Body-powered (mechanical)
A durable mechanical approach in which shoulder and trunk movements are transmitted to the elbow and terminal device through a cable system.
Targeted muscle reinnervation (TMR)
A surgically supported approach that, in some cases, aims to provide access to more muscle signals by redirecting nerves.
Learn moreCoordination and learning
At this level, managing several movements together requires structured training.
Multi-joint control
Managing the elbow and terminal device in sequence or together requires coordination that takes time to learn.
Suspension and comfort
Appropriate suspension of the upper arm socket is important for carrying the prosthesis securely and for comfort throughout the day.
Gradual progress
Goals are set individually; skill in use develops step by step with regular follow-up.
The application process
Physician's Prescription / Medical Report
The application begins with a specialist physician's prescription/medical report.
Assessment and Measurement
The condition of the residual limb, muscle signals and goals are assessed; the socket, elbow and control method are planned.
Trial and Fitting
The socket, elbow joint, wrist and terminal device are fitted; adjustments are made according to the individual.
Training and Follow-up
Multi-joint control training is provided; regular check-ups and adjustments are provided.
Frequently asked questions
How does the elbow work in an above-elbow prosthesis?
Since there is no natural elbow, a prosthetic elbow joint takes on the bending and straightening function. This joint can be locked and released mechanically or electronically; it is controlled by muscle signals or body movement.
Why does control at the above-elbow level require more training?
Since both the elbow and the terminal device have to be managed, the coordination of several movements is involved. This coordination is acquired through structured training after the trial fitting.
Is TMR always necessary at this level?
No. Targeted muscle reinnervation is an approach considered only in suitable cases. Whether it is necessary is determined by the physician's assessment.
This content is for informational purposes; please consult your physician for diagnosis and treatment. Applications are carried out at our licensed center locations in line with a specialist physician's prescription/medical report.
