Press-Fit Osseointegration for the Forearm Amputee

This case illustrates an approach to managing the forearm limb replacement of a skeletally mature patient following traumatic third-degree burns and subsequent amputation. This patient’s care was provided in multiple stages including implantation of osseointegrated prostheses in both the radius and ulna intramedullary canals along with the fitting of a motorized hand and wrist controlled via a bicep myoelectric cuff. A major technical challenge to overcome was the design of the forearm external prosthesis adapter: Almost all prosthetic limbs are a single anchor connector, but the forearm is unique in that pronation and supination are a major and critical functional component. Of note, this patient is a bilateral upper limb amputee and underwent concurrent contralateral (right) limb replacement; this entry focuses on the left forearm.