Upper extremity amputations significantly impact an individual’s physical capabilities, psychosocial well-being, and overall quality of life. The level at which an amputation is performed influences residual limb function, prosthetic compatibility, and long-term patient satisfaction. While surgical guidelines traditionally emphasize maximal limb preservation, prosthetists often advocate for amputation sites that optimize prosthetic fit and function, highlighting the need for a collaborative approach. This review examines the discrepancies between surgical and prosthetic recommendations for optimal amputation levels, from digit amputations to shoulder disarticulations, and explores their implications for prosthetic design, functionality, and patient outcomes. Various prosthetic options, including passive functional, body-powered, myoelectric, and hybrid devices, offer distinct advantages and limitations based on the level of amputation. Prosthetists emphasize the importance of residual limb length, not only for mechanical efficiency but also for achieving symmetry with the contralateral limb, minimizing discomfort, and enhancing control. Additionally, emerging technologies such as targeted muscle reinnervation (TMR) and advanced myoelectric prostheses are reshaping rehabilitation strategies, further underscoring the need for precise amputation planning. By integrating insights from both surgical and prosthetic perspectives, this review highlights the necessity of a multidisciplinary approach involving surgeons, prosthetists, rehabilitation specialists, and patients in the decision-making process. A greater emphasis on preoperative planning and interprofessional collaboration can improve prosthetic outcomes, reduce device rejection rates, and ultimately enhance the functional independence and well-being of individuals with upper extremity amputations.

Purpose: Bias and discrimination are prevalent in surgical training and practice, affecting the learning environment and patient outcomes. While many surgical training programs have recognized that awareness of cultural issues and discrimination are important, most lack structured approaches to address them. This study’s aim was to evaluate the impact of a cultural humility curriculum on self-reported strategies for addressing bias among surgeons and learners. Methods: In 2021 a needs assessment was performed to assess surgical program culture. In response, we developed a cultural humility curriculum which consisted of hour-long sessions presented at surgical grand rounds conference. An evaluation survey was distributed in May 2024 eliciting demographics, number of sessions attended, feedback on relevance of the curriculum, and whether participants felt equipped with strategies for addressing discrimination. Chi-square tests determined association between number of sessions attended and question responses. Results: Of 51 who responded to the evaluation, the majority were male (61%) and white (65%). 41% were medical students, 20% residents, and 33% attending physicians. 71% said the curriculum provided them strategies for addressing issues of discrimination and 44% said they had used the strategies. Those who attended > 10 sessions used strategies more often (69%) than those who attended 6–10 sessions (62%) and 1–5 sessions (11%), p = 0.011. Among medical students (n = 19), 48% said the curriculum positively influenced their perception of the field and 29% said it positively influenced their desire to pursue a surgical specialty. Among sexual minority students (bisexual or gay students, n = 3), 100% said they were more likely to pursue a surgical specialty after participating in the curriculum. Conclusions: A cultural humility curriculum at our institution provided learners and surgeons with strategies to address discrimination in the workplace and positively influenced medical student perceptions of the surgical field.