Managing the upper extremity amputee: a protocol for success.

Since the beginning of Operation Enduring Freedom and Operation Iraqi Freedom, over 541 clients with major limb amputations have been seen in the Military Healthcare System. As a result of the nature and severity of injuries and the prevalence of concomitant injuries seen in this population, amputee care has become a specialized type of rehabilitative care at Walter Reed and Brooke Army Medical Centers. To streamline and accommodate the needs of clients with upper extremity limb loss, a five-phased upper extremity amputee protocol of care was developed. The five phases of the protocol include acute management; preprosthetic training; basic prosthetic training; advanced prosthetic training; and discharge planning. For the readers ease, these phases will be presented in the following categories: acute care, subacute care, and long-term rehabilitation needs. Furthermore, this article seeks to offer insight into the ideal treatment of an individual with upper extremity limb loss based on experience and collective expertise of the authoring therapists.