Fig 1.
Bionic reconstruction in a patient with complete BPI.
A, A 54-year old patient with a flail, atrophic left arm following a BP avulsion injury with a denervation time of 7,5 years. Picking up a small light-weight ball during functional testing is impossible with the functionless hand. B, Prosthetic arm replacement after elective amputation of the left arm at glenohumeral level. C, The prosthetic arm is driven by two electromyographic signals, which are intuitively controlled by the patient (Cutaneous EMG-sensor position on infraspinatus muscle and pectoralis major muscle). D, Prosthetic usage in daily life activities. BP, brachial plexus. BPI, brachial plexus injury.
Table 1.
EMG signals in all patients used for prosthetic control.
Fig 2.
Scheme illustrating the „Vienna psychosocial assessment procedure“.
The assessment procedure is an integral component of the treatment algorithm for bionic reconstruction in patients with complete brachial plexus injury. The pre-surgical psychosocial assessment prior to elective amputation includes qualitative findings obtained from a semi-structured interview and quantitative metrics obtained from three questionnaires. The intended purpose of this assessment was to evaluate the overall psychosocial status of a patient, to uncover psychological disorders which would preclude successful prosthetic reconstruction and to offer psychological support where appropriate. EMG, electromyographic. a The complete treatment algorithm for bionic reconstruction ranging from identification of eligible patients to final prosthetic fitting can be found here: [19].
Table 2.
Psychosocial topics of the semi-structured interview for the assessment of candidates for bionic hand reconstruction.
Table 3.
Interview item response data.
Table 4.
SF-36 Health Survey data at initial evaluation and after bionic reconstruction.
Table 5.
FKB-20 body image questionnaire data.
Fig 3.
Pain was assessed at initial evaluation and after bionic reconstruction with a mean follow-up period of 10 ± 6 months.