Limb Deficiency and Prosthetic Management. 1 Limb Deficiency and Prosthetic Management. 1. Decision Making in Prosthetic Prescription and Management  Virginia S. Nelson, MD, MPH, Katherine M. Flood, MD, Phillip R. Bryant, DO, Mark E. Huang, MD, Paul F. Pasquina, MD, Toni L. Roberts, DO  Archives of Physical Medicine and Rehabilitation  Volume 87, Issue 3, Pages 3-9 (March 2006) DOI: 10.1016/j.apmr.2005.11.022 Copyright © 2006 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 ISO/ISPO designation of levels of transverse deficiencies of upper and lower limbs. Note that the skeletal elements marked with an asterisk are used as adjectives in describing transverse deficiencies; for example, transverse carpal total deficiency. A total absence of the shoulder or hemipelvis (and all distal elements) is a transverse deficiency. If only a portion of the shoulder or hemipelvis is absent, the deficiency is of the longitudinal type. Reprinted with permission.2 Archives of Physical Medicine and Rehabilitation 2006 87, 3-9DOI: (10.1016/j.apmr.2005.11.022) Copyright © 2006 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 Description of longitudinal deficiencies of the upper limb using the ISO/ISPO system. *Digits of the hand are sometimes referred by name: 1, thumb; 2, index; 3, middle; 4, ring; 5, little (or small). Reprinted with permission.2 Archives of Physical Medicine and Rehabilitation 2006 87, 3-9DOI: (10.1016/j.apmr.2005.11.022) Copyright © 2006 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 Description of longitudinal deficiencies of the lower limb using the ISO/ISPO system. *The great toe, or hallux. Reprinted with permission.2 Archives of Physical Medicine and Rehabilitation 2006 87, 3-9DOI: (10.1016/j.apmr.2005.11.022) Copyright © 2006 American Academy of Physical Medicine and Rehabilitation Terms and Conditions