Transradial (forearm) amputation is ideally performed at the junction of the middle and distal thirds of the forearm, preserving rotation and leaving room for a prosthetic wrist unit. More distal levels heal poorly when circulation is compromised.
Transradial Amputations
Optimally performed at the junction of mid and distal thirds of the shaft as amputations through distal 1/3 are less likely to heal if the circulation is compromised in any way due to the thin skin and limited subcutaneous tissue distally
- Amputations can be performed further distally, however, if the circulation is fully intact
Rotation and strength proportional to length retained
Retain at least 4cm of prox ulna for elbow flexion
- Can reattach biceps to proximal ulna to allow for prosthesis fitting
Utilise FDS flap over bone ends
Krukenberg Procedure
- Rarely performed
- Utilised in patients with bilateral upper limb amputations — especially those who are blind and/or in countries where patients can’t access prostheses
- Converts long forearm stump into pincer controlled from pronator teres
- Need sufficient bony length past the attachment of pronator teres and less than 70deg elbow contracture
- Success depends on strength of pronator teres, sensation of forearm and mobility of elbow and forearm at proximal radioulnar joint
- Most patients are able to perform basic functional tasks after the procedure
Author Contributions
Page written by Dr James Drummond
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.