Orthotic & Prosthetic Care Offers Patients A Second Chance
20 Apr 2017
Appreciating the role of prosthetists and orthotists begins with understanding the services we offer. Our core competency is to provide rehabilitation devices that either replace a missing body part (prostheses) or support and protect anatomical structures to facilitate healing, relieve pain or promote safe ambulation (orthoses).
The process begins with a detailed patient history and physical to gain a clear understanding of the patient’s condition, physical capabilities and lifestyle goals. This step often involves consultation with the patient’s physician and/or surgeon, family members, a social worker, and other rehabilitation practitioners involved in delivering care.
Next come careful anatomical measurements and observations to assist in the assembly process, typically involving a positive model of the anatomy using casting techniques or CAD/CAM technology. In the assembly process, practitioners combine the “science” of their training and applicable technology with the “art” of their accumulated experience and personal appreciation for the patient’s needs and abilities. When the finished product is delivered, our role shifts to one of monitoring and upkeep to ensure proper fit and function are maintained.
Although some prostheses are created for largely cosmetic reasons, the major focus of prosthetic practice is on restoration of function to compensate for the loss or congenital absence of a portion or all of an arm or leg.
Upper-extremity prostheses range from partial or complete finger replacements to systems addressing complete arm loss at or above the shoulder. Most common are transradial (below-elbow) limbs typically consisting of a socket, which fits over the remaining (or “residual”) human anatomy, and a hand or hook-type terminal device, sometimes with a functioning wrist component. Transhumeral (above-elbow) systems generally add a functioning elbow.
Traditional upper-limb prostheses are mechanically controlled and powered by cables actuated by residual limb motion. A newer option, myoelectric control, provides powered actuation of prosthetic hand, and possibly wrist and elbow components, using electrical signals generated in the patient’s residual limb. Lower-extremity prostheses compensate for limb loss ranging from a single toe to an entire leg at the hip or even higher. Transtibial (below-knee) systems incorporating a socket, prosthetic foot and connecting pylon are by far the most common, followed by transfemoral (above-knee) systems, partial foot prostheses, and replacement limbs for dis-articulations through the ankle, knee or hip joints. The degree of difficulty increases the higher the level of limb loss.
For most of history, the primary functional role of lower-limb prostheses has been to provide weight bearing for standing and ambulation: The wearer provided all power through residual limb musculature. Now, the future of lower-extremity prosthetics may just be coming into sight with the development of the first electrically powered knee, ankle and foot components, which in time could revolutionize prosthetic science.
Orthotic devices are fabricated for all parts of the lower and upper extremities and the spinal and cervical regions. Orthoses are generally named and classified by the area of the body to which they are applied. For example, a TLSO is a spinal orthosis encompassing the thoracic, lumbar and sacroiliac regions of the trunk. Likewise, a KAFO extends from the knee downward to include the ankle and foot.
Orthotic devices can be as minimal as a pair of foot orthoses for plantar fasciitis or as involved as a cervical-spinal orthosis to protect and promote healing for a major spinal injury. Some are used for a limited time following an injury, others may be applicable throughout an individual’s lifetime for managing symptoms of diseases such as M.S., cerebral palsy and polio. The list of different orthosis designs currently in use is exhaustive with a significant portion being dedicated to pediatric applications.
Please call one of our offices in Beaumont, Nederland or Jasper, Texas. Your initial consultation is free.