Shoulder disarticulation is when the entire arm is removed, but the shoulder blade (scapula) and collar bone (clavicle) are still present. In the forequarter amputation the scapula and clavicle are also removed. The major difference between these two levels is that some shoulder movement is retained with a shoulder disarticulation. The forequarter amputation also makes the body appear asymmetrical as the shoulder width is reduced significantly.
While it is possible to provide a complete prosthetic arm, many patients opt for a simpler shoulder cap, especially for a forequarter amputation. These shoulder caps provide protection for sensitive areas, help restore symmetry and allow clothes to sit more naturally.
Whether you decide to be fitted with a full prosthesis or a shoulder cap, the process begins in the same way; we take a plaster mould of your body to allow us to make a socket that provides an intimate fit for optimal comfort and function. The socket is generally made from fibreglass, but leather can also be used. For a full prosthesis, elbow, wrist and hand components are then attached to the socket. The socket is held in place with either a harness or a small vest.
There are two basic types of prosthetic arm: dress limbs and work limbs. Dress limbs look cosmetically appealing but provide little in the way of function. Work limbs might look a little more unusual but can give a great deal more functionality. Most amputees at this level will opt for a dress limb as a work limb can be very heavy and rather difficult to control. A myoelectric work limb, which uses muscle contractions to control motors within the hand, wrist and elbow, can be very effective for high-level upper limb amputees.