Operations in upper extremity amputees.

The surgeon is obligated to prepare the patient mentally as well as physically for amputation. Acceptance of his loss by the patient, his family and contemporaries is important in his adjustment to his environment. He must provide the best stump possible, direct the postoperative shrinking and conditioning of the stump, prescribe the prosthetic device best suited to the needs of the individual, make sure it fits and functions, and that the patient is instructed in its maximum use. There are definite indications for ablation of a part. All possible length in the upper extremity should be preserved. Amputation in children with congenital deformities should usually be postponed until demanded by the family. The growth centers should be preserved if feasible. Congenital upper extremity amputees should ordinarily be fitted within the first two years.Neuromata, spurs, redundant tissue, scars, and phantom pain should generally be treated by other than surgical methods. Revisions, including cineplasty, should be undertaken only after careful study and when there are clear indications that benefit to patient will ensue.