Upper extremity prosthetics is a very specialized area within the prosthetics field due to the low incidence and catastrophic nature of these injuries. Upper extremity prosthetic limbs require innovative and case-specific solutions. At POSI, we will provide you with an education and overview of all options available. Below are the four most popular upper extremity prosthetic options.
POSI silicone restorations utilize the finest materials to create devices that are attractive, durable and low maintenance. Our “state of the art” fabrication and repair departments provide expedited fittings and repair for every type of electric controlled prosthesis. Due to our high volume of upper extremity case management, the POSI process includes a unique “loaner” program that reduces the down time associated with repairs on more sophisticated components.
Some individuals choose not to wear a prosthetic limb, they find that they can perform all needed tasks without the assistance of a prosthesis. If you are in question as to whether a prosthesis is right for you, schedule an evaluation to see options available to your specific needs.
Passive Design Prosthetic Limbs
Some amputees do not need a dynamic or active prosthesis. For those in this group, we have a variety of passive prosthetic limb options.
A passive prosthesis provides a restoration of body symmetry. The prosthesis tends to remove the conspicuous nature of an injury or limb loss and adds weight to the human torso which balances out the spine for better alignment. It also offers protection to the residual limb. These types of prostheses can be designed very simply or can be dramatic life-like restorations.
At POSI, we use only the finest materials to fabricate these silicone restorations. In casting, we often use the sound side to duplicate the design from the involved side. Details, right down to the fingerprints, are copied into the restoration. The prosthesis is painted and highlighted in order to assure a very close match in skin color and texture. We even include hair if desired.
Some advantages to passive designs include: little or no harnessing for suspension, low maintenance, and durable materials. Disadvantages of passive prosthesis include: no active control of a terminal device and limitation of bi-manual activities.
Myo-electric / External Powered Prosthesis
This prosthetic limb design eliminates the need for a harness system to capture motion in order to control the terminal devices and elbow. Today, there are numerous methods and control mechanisms which relay information to the terminal device hand and elbow often by a micro-processor.
- Myo-electrics use surface electrodes to pick up signals from the remaining musculature in the residual limb. These signals are used to tell the terminal device, wrist rotator or elbow to open or close, move up, down or rotate. If a muscle test shows there is not enough electrical input available from a particular muscle group, we can use switches or touch pads to operate the componentry. Most new technology uses some type of micro-processor (tiny computer), which allows the prosthetist to customize and refine the signals for operation of the prosthesis.
- Externally powered prostheses use batteries to power the motors at the terminal device, wrist and elbow. The technology in batteries has improved so much that we now use lithium ion and nickel metal hydride batteries in many of our designs. These high-tech batteries allow the prosthesis to be used for up to three days between charges. Advantages for externally powered prostheses are an increase in grip force available at the hand and the elimination or reduction of a harness surrounding the unaffected side. It also allows for a larger area or scope of function around the body. Disadvantages of powered prostheses include cost, weight, rough duty, and unclean environments. Today with the advent of new processors and the eliminated of hard wiring as in previous designs, powered prostheses are now considered quite dependable and durable.
With the new silicone technology available, the cosmetic look of the prosthesis can be matched to resemble the sound side very closely. Since there is a host of options for terminal devices, wrists, elbows and control mechanisms, we are careful to select only those agreed upon after the amputee has been educated on all of their options.
Activity Specific Prosthetic Limbs
Activity prostheses encompass any specific activities or needs that have not been addressed through the previously mentioned options. They may include a particular hobby or interest such as fishing, swimming, golf, billiards, photography. They can be vocation specific, such as construction, crane operator, drummer or machine operator. Most tasks can have a specific prosthesis design that will assist with the operation of one’s particular needs. Many times these designs are very unique to the individual’s needs and their personality.
The above types of upper extremity prostheses are only a brief overview of the options available today and should not be considered all-inclusive. If you have any specific questions regarding these Upper Extremity options, please Contact Us to schedule a complimentary consultation.
Socket and Suspension Systems
Style and fit will be unique to the patient’s needs and activity level. There are many systems available; each option will be discussed at length during your visit. At POSI, we encourage and welcome your participation in the design process. Our practitioners have experience working with a variety of socket designs for each level of amputation. Designs are chosen on an individual basis from information gathered during your initial evaluation.
Socket fit has the biggest impact on success with a prosthesis. There is a correlation between proper fit and perceived weight of the prosthesis, an ill-fitting socket will feel heavy and difficult to manage. Well-fitting sockets should have increased proprioceptive feedback, anatomical control, decreased energy expenditure, total contact, and most of all, be comfortable.
Closely related to the design of the socket is the suspension, or how the socket remains in place on the patient’s limb. Suspension mechanisms are incorporated as part of socket design, and will therefore be chosen prior to casting. Suspension can be achieved through a mechanical lock, suction, or capture of the anatomy.
- Mechanical lock is achieved by the incorporation of a pin or lanyard attached at the end of a roll on liner which engages into a lock in the socket.
- Suction suspensions are achieved through a number of methods including seal-in liners and direct skin contact. In addition, air may be evacuated via pump to achieve elevated vacuum.
- Anatomical suspension is achieved when the contours of the socket capture and hold onto the contours of the patient’s body.
All suspension systems are discussed with the patient to determine which system will work best for their lifestyle and activity level.
Symptoms of a Poor Fitting Socket
- Unable to progress to expected goals
- Feels like it is a lot of effort and concentration to work the prosthesis
- Poor confidence
- Skin breakdown, callus, or unusual discoloration
- Significant space between residual limb and socket
Results of a Poor Fitting Socket
- Components will be unable to be used to their full potential
- Regardless of your and your medical team’s efforts, you will be unable to achieve goals
- Increased risk of damage to skin and joints
- Increased energy expenditure
SCHEDULE YOUR COMPLIMENTARY EVALUATION TODAY. Marlton Office: 856.810.7900 Horsham Office: 215.328.9111
POSI prosthetist and technicians are trained and certified by the following manufactures for use of their products:
100 Brick Road, Suite 315
Marlton, NJ 08053
440 Horsham Road, Suite 2
Horsham, PA 19044