Disclosures: Aileen L. Giordano, MD: Nothing to disclose

Case Description: A patient with a right congenital transradial limb deficiency was admitted for comprehensive inpatient rehabilitation (CIR) following a right internal carotid artery occlusion with resultant dense left hemiplegia, hemisensory loss, dysphagia, and dysarthria. He had never used a prosthesis as an adult, instead relying on his left upper extremity to perform functional tasks. Despite intensive inpatient rehabilitation, he had limited motor recovery and was unable to resume use of his left upper extremity for functional tasks. He was therefore fitted with a right residual limb cuff to facilitate performance of activities of daily living (ADLs). At the time of discharge, his left upper extremity had trace movement in a flexor synergy pattern and he was requiring minimal assistance for ADLs and transfers. In order to optimize his functional independence, he was referred to a prosthetist for his first right upper extremity prosthesis since childhood.

Setting: Acute Inpatient Rehabilitation Hospital

Patient: A 71-year-old man with a right congenital transradial limb deficiency and acute ischemic stroke.

Assessment/Results: After transitioning to an outpatient rehabilitation program, the patient’s left sided spastic hemiparesis improved such that he could flex and abduct his left shoulder partial antigravity. He was fitted with a body-weight powered right upper extremity prosthesis, and he continued with therapies for prosthetic training. At last evaluation, the patient was incorporating the prosthesis into ADL performance, and he was very pleased with his functional progress.

Discussion: This is the first reported case, to our knowledge, of new upper extremity prosthesis use in an adult patient with congenital transradial limb deficiency following stroke-related dominant hemiplegia.

Conclusion: Adults with congenital limb deficiency who previously did not use a prosthesis can still benefit from introduction of a prosthesis following new onset hemiplegia.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2019

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/introduction-of-an-upper-extremity-prosthesis-following-stroke-with-resultant-hemiplegia-in-an-adult-patient-with-congenital-transradial-limb-deficiency-a-case-report/