What is a congenital amputation/transverse deficiency of the upper limb?
This happens when the limb doesn’t develop fully during the very early stages of its development. The limb bud can stop growing at various levels – shoulder, above elbow, below elbow or wrist level.
![Wrist level congenital amputation](https://www.reach.org.uk/wp-content/uploads/2024/06/image-27.png)
![Below elbow congenital amputation](https://www.reach.org.uk/wp-content/uploads/2024/06/image-28.png)
![Above humerus congenital amputation](https://www.reach.org.uk/wp-content/uploads/2024/06/image-30.png)
![Whole limb congenital amputation](https://www.reach.org.uk/wp-content/uploads/2024/06/image-29.png)
It is usually seen in isolation and affects one limb only. No familial incidence has been shown.
Sometimes tiny digits/’nubbins’ are seen at the end of the amputation stump.
What causes congenital amputation/transverse arrest?
It is thought that something affects a few cells in the growing end of the limb bud at a very early stage of the development of the baby, before the mother even knows she is pregnant.
How is congenital amputation treated?
Most children adapt well. The child will use the gap between the arm and the body and/or the elbow and/or both hands together to hold objects. The skin of the arm and little digits, if present do have feeling which is very useful for the child.
Prosthetic limbs are available in many different forms and the technology is advancing very fast
- Purely cosmetic
- Myoelectric
- Mechanical/3D printed
- Task orientated – e.g. Koala mitt
The NHS/HSE rehabilitation service will offer advice on the use of these at any stage of your child’s journey
Surgery may occasionally be necessary if the end of the amputation stump/nubbins become inflamed.
Babies and children do not usually feel any pain in their amputation stump but it may feel cold and change colour at times. Simply keep the whole child warm.