F-2-21-03
UTILITY OF SENSORY PROJECTION IN USING A WORK ARM TO OPERATE A PERSONAL COMPUTER
Yoshihisa Tsukamoto (Kurashiki Central Hospital, Kurashiki, Japan)
Herein is reported the case of a 42-year-old man with a very short (7cm: 29%) right forearm amputation who has made skillful use of a work arm in operating a personal computer. The patient's work arm consists of a single wall socket and a stick. He has been making allying as a designer using this work arm in the field of advertising for the past four years. The patient experiences touch sense at the tip of the stick, which I believe to be sensory projection from the stump of his arm. Sensory projection is a phenomenon in which a person feels sensation outside of the body. When we use a tool, such as a screwdriver, we feel touch sense at the tip of the tool, but also in the hand holding the tool. In the case of amputee, this touch sense is felt where a limb or digit no longer exists. The patient could identify the position of the stick without looking, and he testified that he recognized the orientation of the tip of the stick as the index finger of his phantom limb. With his eyes closed, he was able to tap all of the keys of a personal computer with his work arm. I believe this action depends on sensory projection oriented with the phantom limb.
F-2-21-04
KRUKENBERG OPERATION AND UPPER LIMB AMPUTEE REHABILITATION: INDIAN EXPERIENCE
Dr. Pradip D. Poonekar (Artificial Limb Centre, Pune, India)
Krukenberg procedure for upper limb amputees though introduced in 1916 was quite extensively used only after World War I and II. It fell into disrepute in many countries for various reasons. However this technique is regularly undertaken in Artificial Limb Centre, Pune, India, with good to excellent results. The prehensive action with normal tactile sensation in the radial and ulna rays of the Krukenberg stumps is the key factor. The dividends of this procedure is greatest in the blind and bilateral upper limb transradial (below elbow) amputees which then takes the function of the eyes in the blind. The principles of the technique and its variations are highlighted. The procedure not only enables the amputees to do the various activities of daily living but also a versatility which matches the normal hand. The patients those who are few days after surgery to those who are 30 years after surgery are revisited for the benefit of the other upper limb amputees.
