Shoulder Level Amputation: Forequarter and Brachial Plexus-Level Amputation

Shoulder-level amputations, including forequarter amputation and shoulder disarticulation, are very uncommon but can be incredibly devastating. Unlike other levels of upper extremity amputation, these procedures are indicated based on etiology, namely trauma, tumor, or infection. Depending on the emergent need for the procedure and if time allows, physical examination and advanced imaging modalities can be utilized for perioperative planning. Most likely, however, there will be a significant need for revision surgeries, such as targeted muscle reinnervation (TMR), following index amputation. These surgeries can dramatically improve a patient's quality of life, by allowing them to function through a myoelectric prosthesis or to enable them to live without the burden of phantom limb or neuroma pain.