Prosthetics – An Education Of Artificial Limbs And Limb Replacement For Amputees
The decision to get a prosthetic replacement limb represents a major step forward for an individual who is ready to continue life and pursue his or her dreams.
In the world of prosthetics, function is king, and most amputees are constantly searching for the level of function they enjoyed before they lost their limb. With the introduction of micro-processor-controlled limbs, amputees are closer to their goals than ever before.
Advanced technology has greatly benefited the field of prosthetics in the last few years. Today’s prosthetic limbs are made of space-age materials that provide increased durability and function. The end result is that prostheses today can be as much lighter than prosthesis made even just a 5-10 years ago.
In addition, many prosthetics make use of bionic technology. These types of prosthetics are called myoelectric prosthetics.
The computer technology in these types of prosthetics has helped thousands of amputees return to daily activities that they never dreamed possible again. Physically challenged patients are now able to return to most all activities – gardening, running, golfing, fishing … whatever they wish to do.
The licensed, caring professionals at LeTourneau Prosthetics use the latest technology with the prosthetics they offer. In fact, LeTourneau Prosthetics has even been featured on NBC, CBS, ABC, the History Channel, Family Circle magazine, and local newspapers for advancements in prosthetic and orthotic application designs. They were the world’s first orthotic and prosthetic firm to offer computer-designed prosthetics, dry hydrotherapy and a computer gait analysis lab all in one facility.
The philosophy practiced at LeTourneau Prosthetics is that every client should be exposed to a number of prosthetic options and have an opportunity to ask questions so they can decide which option is appropriate for their lifestyle and needs. The company’s unique team approach encompasses the input of a several medical professionals, including a patient’s family physician, a prosthetic specialist, insurance case managers and an experienced medical doctor who works with the company.
“Every individual that comes into our offices as a client, is a hero,” says Tom LeTourneau, founder of LeTourneau Prosthetics in Beaumont, Texas.
Prosthetic technology today offers artificial limbs with significantly improved function. This type of prosthesis offers tremendous results. The computer chip actually reads each step then applies the resistance needed instantaneously to the pneumatic knee unit. With the introduction of micro-processor-controlled knee systems, most amputees can achieve the level of function they enjoyed before amputation. For many, the C-Leg is proving to be an excellent solution.
One Patient’s Story
Mark D. worried about ever returning to his former activity level.
“I felt like I was going to fall down all the time,” he recalls. For example, “Going down ramps, I’d have to stiff leg it down, which is not very efficient, or comfortable.”
Mark readily accepted the opportunity to switch to a C-Leg. The results have been dramatic.
“It just feels great; the stability is just incredible,” he says. “I knew that the first time I put it on. Now I don’t have to think about each step like I did with my previous prosthesis. I can move freely, speeding up or slowing down at will. My gait is natural instead of artificial.”
With the C-Leg, Mark has regained most of his former abilities and activities.
“Knowing I can do everyday tasks as a dad, husband and employer has changed my life,” he says. “My wife even has me back on the dance floor!”
C-Legs utilize computer-controlled hydraulics that provides amputees natural gait. This technology actually can emulate the spring in a normal foot. The C-Leg is one of the most comfortable prosthetic designs available anywhere in the world. The prosthetic’s internal computer adjusts itself for each step at the rate of 50 times per second.
What Are Prosthetics?
Too often, we take things for granted. Most people are born and raised with all of their body parts functioning perfectly. Our bodies can be thought of as amazing biological machines. Our hands can perform complex things, like playing the piano or lifting heavy objects, while our legs enable us to walk, run, and jump.
People may lose a limb due to accident, injury, or disease. If a part of the body is amputated, whether it is a complete hand or a small toe, that person then loses his or her ability to perform normal skills or activities in their daily life. This is when the importance of prosthesis comes into the picture.
Definition of Prosthesis
The term prosthesis is used in medicine to represent an artificial device that can be used to replace a missing body part. Although an artificial limb is often the first image that comes to mind regarding the term prosthesis, it can actually refer to artificial replacement of any part of the body. For example, false teeth are known as dental prostheses, and an artificial replacement of the jawbone is called a maxillofacial prosthesis. A person who uses a removable prosthesis, for example, an artificial hand, may want to have more than one available for different types of tasks. Other types of prosthetic devices are permanently implanted, like a tooth or artificial hips.
Prosthetic limbs are valuable to amputees because they can help a person recover some capabilities that were lost with amputated legs or arms. While prosthetic devices can’t match the exact same functionalities of biological limbs, their capabilities have advanced significantly in recent years. Research advances every day in the field of prosthesis development and technology, and artificial limbs are becoming increasingly much more like real limbs.
Modern Advances in Prosthetic Technology
Modern prosthetic devices are made using advanced plastic and carbon fiber composites. These materials make the limb much lighter yet stronger and look more realistic. With the help of electronic technology, prosthetics in today’s world give the user more control. Modern prosthetic devices are capable of automatically adapting their functions in performing certain tasks, namely holding something or walking. The prosthetic can also be custom made and look however you choose. You can even accessorize it with a favorite sports team’s logo, your favorite color or even a designer style. The prosthesis can be designed to reflect your unique personality.
Types of Prosthetics
Prosthetics can be classified into three major categories for the patients: cosmetic prosthesis, body-powered prosthesis, and myoelectric externally powered prosthesis.
Cosmetic prosthetics can be inexpensive, but they offer limited movement and can only grip light objects passively. This type of prosthetic is designed for people who want to use their other limbs for most major functions.
Body-powered prosthetics allows muscles relative to the area to control the prosthetic with cables. While it does allow a greater degree of freedom and enables patients to feel the force, a body-powered prosthetic can control just one movement at a time and can quickly cause user fatigue.
The third type of prosthetic, which is a myoelectric externally powered prosthesis, picks up the electrical action potential in the residual muscles in the amputated limb. Upon receiving the action potentials, the prosthetic amplifies the signal using a rechargeable battery and uses the electric signals to power the motors operating the respective part of the arm. This allows for more freedom and doesn’t require a patient to perform frequent, strenuous muscle contractions. However, they are heavier and more expensive than the other two categories. But they are some of the most advanced and effective prosthesis available for upper limbs.
Basic Prosthetic Limb Parts
Although new materials have replaced the old materials of past centuries, the basic components of prosthetic limbs actually remain the same.
First, the skeleton part of the limb, which is the basic internal frame of a prosthetic limb, is known as a pylon. It gives structural support and is made out of metal rods. Lighter carbon fibers are now also used to make the pylon. Usually, the pylon is covered using a foam-like material. This cover is usually shaped and colored to match the skin tone of the person who is going to use the prosthetic limb so that it looks natural.
The next component of a prosthetic limb is known as a socket, which interfaces with a person’s limb stump or residual limb. This part transforms the forces from the artificial limb to the user’s body. The socket needs to be placed and fitted perfectly so that no irritation occurs with the skin or any tissues. A soft liner is usually given with the interior of the socket, and the patient usually wears a prosthetic sock to get a better fit.
The next part of a prosthetic limb is called the suspension system. This part keeps the limb attached to the body of the user. This suspension system can use several mechanisms, namely straps, belts, and sleeves. Often, the suction mechanism is used in the suspension where the limb fits easily with the residual limb using the help of an airtight seal.
Although the core parts of the replacement limbs may be the same, each prosthetic device is actually very unique and designed for a particular type and category of amputation. For this reason, each device is customized and designed according to the need of a patient.
For example, if the amputation were below the knee or above or below a major joint, the requirement of the type of a prosthetic would vary dramatically. An amputation above the knee is known as transfemoral amputation, which would require a device with a false knee, while an amputation below the knee, called transtibial amputation, would not need an artificial knee, as the patient could use their own knee.
What Is a Prosthetist?
The responsibility to customize a prosthetic device according to the need of the patient is given to a professional known as a prosthetist. This person is an expert and specializes in the fabrication and installation of prosthetic limbs. This person is usually skilled in engineering along with anatomy and physiology.
The assembly and fabrication process consists of several stages. The prosthetist can already begin working with the patient before the amputation. He or she can begin taking measurements and start the fabrication process. When the wound of the surgery has healed after several weeks, a plaster mold made from the residual limb is used as a template for making the duplicate limb.
Computerized digital measurements are then taken for perfection in assembly. More attention is given to the structure of a patient’s residual limb along with the location of muscles, tendons, different bones, and the patient’s health and skin conditions.
Physical Therapy and Prosthetic Adjustments
It is extremely important to undergo physical therapy after the installation of a prosthetic device in order to help the patient get used to using the artificial limb. For example, it can be very difficult to learn to walk using a prosthetic leg, and it can take several months to learn with the proper rehabilitation and training. The prosthetist can then observe the person using the artificial limb and then, if needed, can adjust and fine-tune the device according to the patient’s needs.
The person responsible for this task should give close attention to the interface between the residual limb and prosthetic socket of the patient. The residual limb can shrink after the amputation or due to the lack of use of the muscle. Therefore, it is possible that a new socket may be required in order to accommodate the size reduction.
If the patient is a child, the prosthetist must give special attention to and work closely with them to ensure that the limbs are resized and replaced as needed to keep up with the natural growth of the child.
Typically, a patient needs to visit the prosthetist regularly for different reasons like an adjustment, change of shape or replacement of the prosthetic device. An average prosthetic device has a three-year lifespan according to the National Limb Loss Information Center.
Artificial Limb assembly
The technology involved in prosthetic limb assembly and development is a dynamic and rapidly changing field of research.
If the prosthetic limb is body powered then cables connecting them to other parts of the body can control them. An arm can be controlled using a healthy shoulder for instance. The working shoulder can be moved in certain ways to control the prosthetic device.
Prosthetic limbs are externally powered by motors and servos and may be controlled by a patient in different ways. The patient can use a switch to control the prosthetic device by adjusting the switch or button. The patient adjusts the switches using the other shoulder, or he or she might be able to use remaining muscles in the residual limb to push the switches.
Another way that allows a person control their prosthetic limb is by listening to the muscles still remaining in the residual limb that the patient can still contract. Although the muscles physically press no buttons in this case, their contractions are detected by the electrodes and then used to control the prosthetic limb.
Prosthetic limbs that function like this are called myoelectric.
One of the most advanced technologies that are now being used to control prosthetic limbs is something called targeted muscle re-innervation or (TMR).
Your brain controls the muscles in your limbs by sending direct electrical signals down your spinal cord and then through your peripheral nerves to your muscles. But for an amputated person their peripheral nerves would still carry signals generated in the brain, but those signals would stop where the amputation started and wouldn’t be able to reach the amputated muscles.
The TMR surgical process redirects these amputated nerves to control a substitute healthy muscle elsewhere in the body. As an example, the nerves used to control a patient’s arm can be attached to the patient’s chest muscle by a surgeon. After the procedure, as a patient attempts to move an amputated arm, the control signals that are traveling through the original nerve in the arm will then cause the chest muscles to move instead.
This is important since this electrical activity can be sensed with the electrodes to provide a control signal to the prosthetic limb. This way a person can think or move the amputated arm and the prosthetic arm will be moved instead. Advancement of brain-computer interfacing will allow these artificial devices too much more effectively simulate the nerves and brain, which may be able to restore a sense of touch and allow patients to feel their own artificial limb. This ability will reduce the gap between the prosthetic limbs and the normal limbs they’re replacing.
Fitting Your Prosthesis
Fitting the prosthesis can involve two major phases: the temporary or preparatory prosthesis and the final prosthesis. The longer phase is the first one, which we discussed earlier involving physical therapy and fitting the temporary socket.
In the final prosthesis-fitting phase, the prosthetist decides when the right time comes for the final prosthesis.
Follow-up visits to a prosthetist can be a normal part of your new life. A change in a residual limb, like shrinkage or swelling, or a even significant change in your body weight, may require a follow-up visit with the prosthetist to adjust the fit of the socket.
Prosthetics, just like cars, will need occasional repair or maintenance to keep them working properly. Small adjustments can definitely make a big difference. Proper fit and alignment will go a long way to be sure that your prosthesis always works correctly.
The assembly of prosthesis typically starts with the consideration of how well it will fit. People with different needs may require advanced socket and total contact fit of gel liner. Factors like cost, ease of use, different available size and cosmetics are also considered in the assembly. Also, issues like the weight of the device, rotation of the device in different directions, energy absorption due to the impact on the musculoskeletal system, etc. is also considered when manufacturing a high-performance prosthesis assembly.
If smaller problems with the prosthesis are taken care of right away, then it won’t create a larger one. The risk is that a patient could harm the residual limb or even other parts of their body.
Affording Prosthetics With The Help of Financial Aid
Affordable prosthetics are within your reach! Regardless of the price, it is possible to receive financial aid to get a prosthetic. Medicaid may help since it can pay for health care services for people with lower incomes even though not all people may qualify. However, children, elderly people, and disabled people, along with pregnant woman can always apply in some states, while in other states if you are under the age of 21 you can apply for it. The social security administration can also be contacted to determine if a person is qualified for Medicare or not. Finally, asking a social worker at the hospital or clinic to get more information about any available sources of funding for prosthetic devices may be helpful as well.
Amputation used to be a very debilitating procedure. Most people were confined to wheelchairs or worse to bed. In 80 percent of the cases due to dysvascular problems (poor circulation caused by various diseases such as diabetes, cardiovascular disease, etc.), the individual would wind up losing their other leg within five years of the first amputation. However, that is no longer the case if properly attended with a “Team Approach” philosophy.
While working with your healthcare team we are able to devise the appropriate prosthetic application for your lifestyle and with convenient offices located in Beaumont, Nederland and Jasper, Texas we are just a phone call away. Your initial consultation is free and we can even file all insurance for you.