Upper Limb Prosthetics Options: What You Need to Know

Key Highlights

• Upper limb prosthetics include shoulder, elbow, wrist, hand/fingers, body-powered, and myoelectric systems, each tailored to amputation level and functional goals.
• Key components include socket and suspension, interposing joints, terminal devices, control systems, and materials/alignment for comfort and performance.
• Body-powered prosthetics offer durability, feedback, and lower cost, while myoelectric systems provide advanced control, multiple grips, and fine motor function.
• Choosing the right prosthetic depends on amputation level, activity goals, control preference, training needs, fit, comfort, and budget.
• Successful use requires proper training, adaptation, ongoing maintenance, prosthetist collaboration, and realistic expectations for function and lifestyle integration.

 

Losing or being born without part of an upper limb can bring many challenges—yet today’s prosthetic technologies offer a wide range of solutions. When we talk about upper limb prosthetics options, we refer to the various devices available to replace or support missing components of the arm, from the shoulders down to the fingers. With advances in materials, electronics, and biomechanics, individuals now have more choices than ever to regain function, comfort, and aesthetics.

In this article, we’ll explore the different options for upper limb prosthetics—particularly the types provided for prosthetic elbows, wrist joints, shoulders, fingers, body-powered systems, and myoelectric prosthetic hands. Whether you’re an amputee, caregiver, or clinician, this overview will equip you to understand what’s possible, ask the right questions, and partner more effectively with your prosthetist.

Understanding Upper Limb Prosthetic Components

Before diving into the specific device types, it’s helpful to understand the common building blocks of upper limb prosthetic systems. Key components include:

• Socket & Suspension: The socket is the part that fits onto the residual limb or body (in higher-level amputations) and connects the user to the prosthetic device. Suspension describes how the device stays in place (suction, harness, strap, liner).
• Interposing Joints: These are prosthetic elbow, wrist, or shoulder joints that allow articulation and movement between segments.
• Terminal Device: Often the “end” of the prosthesis—hand, hook, fingers, or a specialized tool.
• Control System: This defines how the prosthesis is operated: body-powered (cables/harness), myoelectric (muscle sensor-based), externally-powered (motors), or hybrid systems.
• Materials & Alignment: Fit, weight, durability, and alignment with the user’s remaining anatomy all contribute to comfort and performance.

 

Understanding these elements will help when evaluating specific device types.

The Different Upper Limb Prosthetics Options

Let’s look at each of the major device categories and how they apply to specific levels of amputation or limb difference.

1. Prosthetic Shoulder Systems (Shoulder Disarticulation / Forequarter)

When the amputation is at or above the shoulder joint—such as shoulder disarticulation or forequarter (including scapula/clavicle) levels—prosthetic systems are complex and involve multiple joints.

Key features & considerations:

• The socket may need to engage the torso, clavicle, scapula, and upper chest for suspension and control.
• A prosthetic shoulder joint (mechanical or powered) may be included to allow arm-lifting, reach, and positioning.
• In addition to the shoulder joint, often an elbow joint, wrist, and terminal device must be incorporated.
• Fit and training become critical: these devices tend to be heavier, more complex, and require good residual strength, core stability, and rehab.
• Control methods vary: body-powered may be less common at this level; externally powered or hybrid systems can be more appropriate.

 

Best suited for: Individuals with very high‐level amputations (shoulder or above) who aim to restore full arm mobility (reach, carry, positioning) rather than just cosmetic appearance.

2. Prosthetic Elbow Systems (Transhumeral Amputation)

When the amputation is above the elbow but below the shoulder (transhumeral), a prosthetic elbow joint is needed alongside a socket, suspension, wrist/hand.

Key features & considerations:

• The elbow joint may be mechanical/hydraulic (locking, adjustable swing) or powered (motorized).
• The fit and alignment must allow safe bending of the prosthetic elbow, correct length, a comfortable socket, and minimal residual limb movement within the socket.
• Control: body-powered cables involving a shoulder harness may still be used; myoelectric elbow/hand combinations are increasingly common.
• Weight, control complexity, and durability are all important factors.
• Training: teaching safe use of elbow bends, reaching, returning to the original position, and balance.

 

Best suited for: Users with amputation through the humerus who wish to restore elbow function and combine with wrist/hand prosthetics for improved reach and activity.

3. Prosthetic Wrist Joint & Terminal Devices (Below-Elbow / Transradial)

For amputations through or below the forearm (transradial) or wrist/hand levels, the prosthetic wrist and terminal device become central to function.

Key features & considerations:

• Wrist joint: allows rotation or flexion/extension of the hand or hook; adds versatility in positioning the terminal device.
• Terminal device: could be a hook, hand, multi-fingered device, or partial hand/fingers. The choice depends on tasks, control preference, and budget.
• Control systems: body-powered systems (cable harness) remain common; myoelectric systems allow grip patterns, multiple functions.
• Fit and comfort: socket design, residual limb shape, suspension method, and daily tasks all influence the choice of wrist/terminal device.
• Activity level: for heavy manual work, a sturdy hook or simple device may outperform a delicate myoelectric hand; for fine motor tasks (typing, eating, manipulation), more advanced options may be justified.

 

Best suited for: Users with forearm or wrist-level amputations who desire functional hand/wrist movement for daily tasks, grasping, positioning, and manipulation.

4. Prosthetic Fingers / Partial Hand Systems

When the amputation or limb difference affects fingers, partial hand or thumb levels, specialized prosthetics offer targeted solutions.

Key features & considerations:

• These may include passive cosmetic fingers, mechanically driven finger devices, small body-powered systems, or motorized finger systems.
• Partial hand devices can combine body-powered/finger-cable systems or myoelectrics for finger movement, pinch, and fine manipulation.
• Fit is crucial: small residual hand segments, glove fit, comfort in high-use tasks like typing, instrument playing, or crafting.
• These devices may allow improved symmetry, better use of the remaining hand, and prevent overuse of the intact side.

 

Best suited for: Individuals with finger amputations, partial hand loss, or thumb absence who want restoration of fine motor control, better grip, and day-to-day function.

5. Body-Powered Upper Limb Prosthetics

Body-powered systems use harnesses, cables, and the user’s own body motion (shoulder, scapular movement) to control the prosthetic function.

Key features & benefits:

• Typically durable, lower cost, simpler maintenance compared to motorized systems.
• Good “feedback”: the user feels the tension in the cable or harness and thus has proprioceptive feedback of grasp force and movement.
• Suitable for environments involving water, dirt, heavy manual work, or when the budget is constrained.
• Drawbacks: harness can be bulky, may require significant shoulder or trunk movement; body strength and range of motion may become limiting; may be less “natural” than myoelectric systems.

 

Best suited for: Users who prioritize durability, real-world robustness, cost-effectiveness, and functional use in manual, vocational, or rugged environments.

6. Myoelectric Prosthetic Hands (Externally-Powered Upper Limb Prosthetics)

Myoelectric prosthetics use sensors (electromyography, EMG) placed on the residual limb to detect muscle signals, which are amplified and used to control motors in the prosthetic hand or terminal device.

Key features & benefits:

• Advanced motorized controls allow multiple grip patterns, wrist rotation, fine pinch, and dynamic movement.
• More natural appearance and control for tasks requiring fine motor skills, expressive gestures, and manipulative performance.
• Drawbacks: heavier, costlier, more maintenance (charging batteries, software updates), may be sensitive to moisture/dirt, may require more training.

 

Best suited for: Users who prioritize high functional performance, fine motor control (e.g., instrument playing, computing, detailed tasks), and who have sufficient residual musculature and training capacity.

Comparative Overview

Here’s a summary comparing each prosthetic type:

How to Choose the Right Upper Limb Prosthetic Option

Selecting the right upper limb prosthetic is a process—one that should be guided by your prosthetist, occupational therapist, and your own functional and lifestyle goals. Here are key considerations:

1. Amputation Level & Residual Limb Condition

• Identify exactly where your limb difference or amputation is (partial hand, wrist, below elbow, above elbow, shoulder). The higher the level, the more components required.
• Assess residual musculature, skin condition, range of motion, and shoulder/trunk strength (especially for body-powered systems).
• Consider any other medical issues (e.g., shoulder pain, back problems) that may be impacted by prosthetic use.

 

2. Activity Goals & Daily Tasks

• What tasks do you want to perform? Light daily tasks? Fine motor work (typing/instrument)? Heavy manual labor? Recreation/sports?
• Do you prioritize aesthetics, function, or both? Some devices emphasize appearance (passive) over movement.
• Think about the environments you’ll be in: water, dirt, and rugged terrain might favor simpler body-powered systems.

 

3. Control Preference & Training

• Body-powered systems require shoulder/harness movement—are you comfortable with that?
• Myoelectric systems require muscle signals, training, and charging, and may be less resilient in certain environments.
• Hybrid options exist (body-powered elbow, myoelectric hand) for certain users.
• Training and rehabilitation are essential across all types; the best device without training will not reach its potential.

 

4. Durability, Maintenance & Cost

• Simpler devices generally cost less and have fewer parts to maintain. Myoelectric devices cost more, require batteries, software, and servicing.
• Insurance coverage varies widely—documentation of functional need, activity level, and justification is often required.
• Consider long-term upgrade potential: you might start with a body-powered system and later upgrade to myoelectric if desired.

 

5. Fit, Comfort & Prosthetist Collaboration

• Work closely with a prosthetist experienced in upper limb prosthetics; having high-level componentry means little if the socket and suspension are uncomfortable.
• The socket interface may need adjustments over time (volume changes, muscle tone changes).
• Ensure alignment, weight distribution, and control system match your body and goals.

 

6. Psychosocial & Functional Adaptation

• Changing arms or hand function affects body image, daily routines, training time, and social adaptation.
• Give yourself time to adapt, practice tasks, and possibly modify expectations.
• Consult occupational therapy for task-specific training (e.g., typing, tool-use, hobbies).

 

Practical Tips for Adapting & Maintaining Your Upper Limb Prosthetic

• Begin slowly, especially when trying new components like a powered hand or a new wrist joint.
• Incorporate prosthetic use into daily routines and gradually increase the complexity of tasks.
• Monitor fit and comfort: socket irritation, harness discomfort, and skin changes warrant early adjustment.
• Keep the device well maintained: cable tension, battery charging, software updates, and lubrication as required (especially for powered joints).
• Stay in contact with your prosthetist: as you increase use, your needs may change (upgrade, different terminal device, new software).
• Practice donning/doffing, device care, and cleaning, especially if you work in demanding environments or with moisture/dirt.
• Set realistic expectations: even the most advanced prosthetic may not replicate every natural function—success lies in matching device to goals and training.

 

Final Thoughts

Upper limb prosthetics options have come a long way—from purely cosmetic arms to advanced myoelectric hands with multiple grip patterns, powered joints, and high levels of dexterity. Whether you’re exploring a prosthetic elbow, wrist joint, shoulder system, finger device, body-powered upper limb prosthesis, or a myoelectric hand, the key is choosing what aligns with your amputation level, lifestyle goals, and willingness to train and adapt.

If you’re ready to explore upper limb prosthetic options in more depth and want custom design, fitting, and ongoing support from a team experienced in upper limb prosthetics, Orthotics Ltd. is here to help you take the next step. Contact us today!

---

Frequently Asked Questions

1. How long will it take to get fitted with an upper limb prosthesis?

It varies depending on the device complexity, level of amputation, socket modifications, and control system. Simple body-powered or passive devices may take a few weeks; advanced myoelectric systems may require several fittings, training, and software tuning, so a couple of months is common.

2. Can I switch from a body-powered system to a myoelectric hand later?

Yes—many users start with a simpler body-powered system and later upgrade to myoelectric or hybrid devices. However, you’ll need to ensure your residual limb, musculature, and socket are suitable for the upgrade and plan for training.

3. Does insurance cover advanced myoelectric prosthetics?

Coverage depends on your insurance plan and medical necessity documentation. Policies often require proof of functional need, activity goals, and comparative justification of cost vs functional benefit.

4. How often should I expect maintenance or replacement of parts?

Maintenance frequency depends on use, environment, device type, and wear. Cable systems may require periodic adjustment; powered systems may need battery, motor, or software servicing. It’s wise to have an annual review at a minimum.

5. Will I get sensation back through the prosthetic?

Most upper limb prosthetics do not restore true biological sensation. However, advancements (haptic feedback, myoelectric control, sensor systems) are beginning to provide more intuitive control and “feedback” of force/pressure. Training and adaptation are key.

---

Sources:

• https://www.ncbi.nlm.nih.gov/books/NBK453290/
• https://www.physio-pedia.com/Overview_of_Transhumeral_Prosthetics
• https://jneuroengrehab.biomedcentral.com/articles/10.1186/1743-0003-8-29
• https://pmc.ncbi.nlm.nih.gov/articles/PMC5054596/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC4968852/