Amputations & Prosthetics

sec_arr Upper Extremities
SECTIONS

Upper Extremity Amputations

Partial Amputation of Thumb at or Distal to Interphalangeal (IP) Joint

LEOs with adequate lengths of the thumb to form a side pinch against the index finger will likely be able to generate adequate grip and have adequate dexterity to safely and effectively perform law enforcement job functions. If due to the length of the remaining digit, there is a question about dexterity, it may be necessary to evaluate the LEO’s performance on task simulations.

Partial Amputation of Single Digit Other than Thumb at or Distal to Distal Interphalangeal (DIP) Joint
LEOs with partial single digit amputations at or distal to the distal interphalangeal joint (DIP) without any skin abnormalities (e.g., well-healed traumatic amputations or post-frostbite with no history or signs of skin breakdown or congenital lack) with or without normal function of the DIP, other than of the index finger, generally have very little impairment that would adversely affect performance of law enforcement job functions.

LEOs with such amputations of the index finger should be individually evaluated for adequate performance of law enforcement job functions such as firearm use.

Partial Amputation of Multiple Digits Other than Thumb at or Distal to Distal Interphalangeal (DIP) Joint on Same Hand
LEOs lacking distal segments of multiple digits on the same hand should be assessed individually for ability to safely and effectively perform required law enforcement job functions. Such amputations may impair dexterity of manipulation tasks.

Digit Amputations Proximal to DIP Joints and Thumb Amputations Proximal to IP Joint
LEOs with the following amputations will most likely be unable to perform various hand grasping and dexterity tasks necessary to safely and effectively perform law enforcement job functions (see Appendix A):

1: lack of thumb proximal to IP joint;

  • cannot close around object = power grasp
  • hold baton
  • use firearms
  • retain weapons
  • restrain suspects
  • hold and manipulate steering wheel

2: lack of two fingers on one hand at the proximal IP joints

  • index and long fingers – fine motor tasks
  • ring and small finger – power grasp
  • loss of one finger in each of these two groupings will likely partially impair both functions

3: lack of one finger at the metacarpophalangeal joint AND the thumb of the same hand at the IP joint.

  • impairment depends on which finger is lost with the thumb
    • ability to compensate for loss of a digit is compromised with loss of the thumb at the IP joint

Amputation of One Metacarpal
Single metacarpal amputations may still allow adequate functionality for performing law enforcement job functions.

Amputation of Two or More Metacarpals
Loss of multiple metacarpals will not allow performance of many law enforcement job functions. The police physician will need to provide appropriate work restrictions.

Amputations Proximal to Metacarpals
Loss of the extremity proximal to the metacarpals will not allow performance of many law enforcement job functions. The police physician will need to provide appropriate work restrictions.

Leos Using A Prosthesis or Prostheses
At the time of this writing, upper extremity prostheses do not provide LEOs with the multi-functionality of grip types necessary for performing law enforcement tasks. Additionally, these devices do not provide the LEO with the dexterity, strength, and proprioception that is necessary to perform several law enforcement job tasks. The police physician will need to provide appropriate work restrictions.