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Upper Extremities

1. The younger the child is at the time of ampu­tation, the easier the transformation of hand dominance.

2. Children with high-level, bilateral upper-limb loss may benefit from a prosthesis for ADLs.

Since limited body movements are available, the child may bene­fit from at least one hybrid or completely externally powered prosthesis. Prior to the consideration of pros­thetic fitting, it is paramount that the child and family begin exploring the use of the child's lower limbs, as independence can also be achieved with feet.

3. At birth, the severely deformed upper extrem­ity often detracts from the identification of more important systemic workup. Although there may not be any other underlying etiologies or comor­bidities, it is essential for the clinic team to explore these possibilities.

4. It is important to teach parents about the loss of sur­face area corresponding to the absent limb. Active children with multiple limb loss have a reduced surface to radiate heat loss, so they may have an increase in sweating and flushing about the head and neck.

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Source: Alexander M.A., Matthews D.J.. Pediatric Rehabilitation: Principles and Practice. 4 th. ĺd. — New York: Demos Medical Publishing,2010. — 540 đ.. 2010
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