Overview of upper limb amputations and prosthetic solutions in Brazil: Insights from the Unified Health System (SUS), 2008–2023

This study aims to present a detailed and updated analysis exclusively focused on upper-limb amputation compared to upper-limb prosthesis distribution in Brazil.

Data regarding both upper limb amputation and prosthesis, from 2008 to 2023, were collected from the Hospital Information System and the Ambulatory Information System of the Unified Health System SUS (SIH and SIA/SUS) of the Informatics Department of the Unified Health System (DATASUS). Descriptive analysis and association measurements were performed.

The proportion of upper-limb prostheses provided by SUS in relation to the total amputations is only 26.39% (excluding finger amputation for accuracy). São Paulo state had the highest number of amputations, nearly twice as many any other state, followed by Minas Gerais, Bahia and Rio de Janeiro. Surprisingly, Amapá (77.72%), Distrito Federal (71.85%) and Rio Grande do Sul (58.73%) presented the higher prosthesis to amputation ratio while Acre, Maranhão, Ceará, Rio Grande do Norte, Amazonas and Mato Grosso had prosthetic assistance rates lower than 10%. The observed trends in the distribution of prostheses over the years show minimal improvement in access.

The findings not only offer upper-limb prosthesis developers insights into the current landscape of upper-limb rehabilitation in Brazil, but also can guide public policy efforts aimed at reducing the incidence of amputations and enhancing access to prosthetic solutions. We also strongly encourage researchers to work closely with the Orthopedic Workshops to improve the current body-powered prosthesis provided by SUS.