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This research focuses on adults with bilateral traumatic amputation of both forearms, a rare condition that greatly affects independence and quality of life. The study evaluates two approaches bilateral hand and forearm allografts transplants and the use of prosthetic forehands. It aims to compare these options in terms of costs, quality of life, usefulness, satisfaction, autonomy, and social integration. The study builds on previous work that demonstrated the feasibility and functional benefits of bilateral hand grafts, despite the need for immunosuppressive treatment and potential medical complications. Participants receive either a bilateral allograft of the hands and forearms or prosthetic forehands. The transplant group must meet specific medical and psychological criteria, including a minimum of three months since amputation and no recent cancer history. The prosthetic group uses prosthetic devices for limb replacement. This non-randomized study conducted by Hospices Civils de Lyon compares these two treatment approaches over a 36-month period. During the study, researchers will monitor treatment costs over 36 months as the primary outcome. Participants will be assessed for quality of life, autonomy, satisfaction, and social integration. Medical evaluations include psychological assessments, kidney function, heart function, and blood pressure control for the transplant group. The study runs until October 2031, and participants will be regularly evaluated to understand the long-term impact and benefits of each treatment option.