Levels of lower extremity amputations: Hemipelvectomy (transpelvic), Hip disarticulation, above knee amputation (transfemoral), through the knee amputations, below knee amputations (transtibial), Ankle disarticulation. Partial foot amputation Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions
Body powered arms to weigh around one-half to one-third of what a myoelectric arm does. Current body-powered arms contain sockets that are built from hard epoxy or carbon fibre. These sockets or interfaces can be made more comfortable by lining them with a softer, compressible foam material that provides padding for the bone prominences. A self-suspending or supra-condylar socket design is useful for those with short to mid-range below elbow absence. Longer limbs may require the use of a locking roll-on type inner liner or more complex harnessing to help augment suspension.
Robots can be used to generate objective measures of patient's impairment and therapy outcome, assist in diagnosis, customize therapies based on patient's motor abilities, and assure compliance with treatment regimens and maintain patient's records. A device known as the controller is connected to the user’s nerve and muscular systems and the device itself. It sends intention commands from the user to the actuators of the device and interprets feedback from the mechanical and biosensors to the user. The controller is also responsible for the monitoring and control of the movements of the device. An actuator mimics the actions of a muscle in producing force and movement.
Infants and children require a specialized approach to their prosthetic care and depend on their parents and their prosthetic providers to patiently take care of their needs during these growing years. Limited communication skills, combined with rapid rates of physical growth mean that paediatric patients require frequent office visits and more careful observation of their progress from month to month. Children are often times much more adaptable than adults. That is why infants who are born with a missing or partial limb, or children who lose a limb through injury or amputation, should be evaluated by a prosthetists as soon as possible. Often it is appropriate for infants and very young children to be fit with a passive prosthesis right away so that the prosthetic limb is incorporated into their developing body image and daily life.
Few low cost solutions have been created especially for children. Underneath some of them can be found. This hand held pole with leather support band or platform for the limb is one of the simplest and cheapest solutions found. It serves well as a short term solution but is prone to rapid contracture formation if the limb is not stretched daily through a series of range of motion
Low cost above knee prostheses often provides only basic structural support with limited function. This function is often achieved with crude non articulating, unstable, or manually locking knee joints. A limited number of organizations, such as the International Committee of the Red Cross create devices for developing countries. Their device which is manufactured by CR equipment’s is a single axis manually operated locking polymer prosthetic knee joint.
Cosmetic prosthesis has long been used to disguise injuries and disfigurements. With advances in modern technology, cosmesis, the creation of lifelike limbs made from silicone has been made possible. Such prosthetics, including artificial hands, can now be designed to simulate the appearance of real hands, complete with freckles, veins, hair, fingerprints and even tattoos. Custom-made cosmeses are generally more expensive while standard cosmeses come premade in a variety of sizes, although they are often not as realistic as their custom made counterparts. Another option is the custom made silicone cover, which can be made to match a person's skin tone but not details such as freckles or wrinkles. Cosmeses are attached to the body in any number of ways, using an adhesive, suction, form-fitting, stretchable skin, or a skin sleeve.
In addition to the standard artificial limb for everyday use, many amputees or congenital patients have special limbs and devices to aid in the participation of sports and recreational activities.
Within science fiction, and, more recently, within the scientific community, there has been consideration given to using advanced prostheses to replace healthy body parts with artificial mechanisms and systems to improve function. The morality and desirability of such technologies are being debated by trans humanists other ethicists. Body parts such as legs, arms, hands, feet, and others can be replaced.
A myoelectric prosthesis uses the electrical tension generated every time a muscle contracts as information. This tension can be captured from voluntarily contracted muscles by electrodes applied on the skin to control the movements of the prosthesis, such as elbow flexion/extension, wrist supination of the fingers. A prosthesis of this type utilizes the residual neuromuscular system of the human body to control the functions of an electric powered prosthetic hand, wrist, elbow or foot. This is different from an electric switch prosthesis, which requires straps or cables actuated by body movements to actuate or operate switches that control the movements of the prosthesis. There is no clear evidence concluding that myoelectric upper extremity prostheses function better than body powered prostheses.
The typical prosthetic device consists of a custom fitted socket, an internal structure knee cuffs and belts that attach it to the body, prosthetic socks that cushion the area of contact, and, in some cases, realistic looking skin. Prosthetic limb manufacture is currently undergoing changes on many levels, some of which concern the choice of materials. A prosthetic device should most of all be lightweight, hence much of it is made from plastic. The socket is usually made from polypropylene. The newest development in prosthesis manufacture has been the use of carbon fibre to form a lightweight pylon. Certain parts of the limb for example, the feet have traditionally been made of wood such as maple, hickory basswood, willow, poplar, and linden and rubber. Even today the feet are made from urethane foam with a wooden inner keel construction. Other materials commonly used are plastics such as polyethylene, polypropylene, acrylics, and polyurethane. Prosthetic socks are made from a number of soft yet strong fabrics. Earlier socks were made of wool, as are some modern ones, which can also be made of cotton or various synthetic materials.
There are multiple factors to consider when designing transtibial prosthesis. Manufacturers must make choices about their priorities regarding these factors.
There are certain elements of socket and foot mechanics that are invaluable for the athlete, and these are the focus of today's high-tech prosthetics companies: Fit athletic amputees or those with bony residua may require a carefully detailed socket fit, less active patients may be comfortable with a total contact fit and gel liner. Energy storage and return storage of energy acquired through ground contact and utilization of that stored energy for propulsion. Energy absorption, Ground compliance, Rotation, Weight, Suspension
Neurocognitive prostheses would sense or modulate neural function in order to physically reconstitute or augment cognitive processes such as executive function, attention, language, and memory. No neurocognitive prostheses are currently available but the development of implantable neurocognitive brain computer interfaces has been proposed to help treat conditions such as stroke, traumatic brain injury, cerebral palsy, autism, and Alzheimer's disease. The recent field of Assistive Technology for Cognition concerns the development of technologies to augment human cognition. Scheduling devices such as neuropage remind users with memory impairments when to perform certain activities, such as visiting the doctor. Micro prompting devices such as peat have been used to aid users with memory and executive function problems perform activities of daily living.
A transdermal intraosseous device for coupling a bone stump to an external prosthetic device includes a bone fixator, an external connector and a plurality of modular interface components. The bone fixator includes a proximal portion configured for anchoring into the bone stump of the patient and a distal portion including a base collar configured for subcutaneous implantation. The external connector has a distal portion for coupling to the external prosthetic device and a proximal portion for coupling to the distal portion of the bone fixator. Each interface component can be removable coupled to the base collar and has different size and shape to provide a surgeon-selected transition between the prosthetic device and the patient's skin