Prosthesis

Lore & Background

Prostheses have been used to replace limbs lost through amputation, which may result from physical trauma, disease, or congenital conditions. A person who has undergone an amputation is sometimes referred to as an amputee. Rehabilitation is primarily coordinated by a physiatrist as part of an inter-disciplinary team including prosthetists, nurses, physical therapists, and occupational therapists. Limb prostheses include both upper- and lower-extremity types, such as transradial (below elbow) and transfemoral (above knee) prostheses. Upper-extremity prostheses are categorized as passive devices, body-powered devices, or externally powered (myoelectric) devices. Passive devices are used for cosmetic purposes or specific activities, while body-powered limbs work via a harness and cable around the opposite shoulder. Myoelectric arms use a battery system and detect muscle activity through techniques like electromyography to control gripping patterns.

Reader's Guide

Prostheses are significant because they restore function and appearance for individuals who have lost body parts due to trauma, disease, or congenital disorders. The design and selection of a prosthetic device must balance aesthetics and function, considering personal circumstances, co-morbidities, budget, and access to care. Lower-extremity prostheses, such as transtibial (below knee) and transfemoral (above knee) devices, require careful fitting and gait assessment by clinical prosthetists, followed by rehabilitation with a physical therapist. Transfemoral amputees use approximately 80% more energy to walk than individuals with two whole legs, while transtibial amputees typically regain movement more readily due to retaining the knee. Advances in materials like carbon fiber and technologies such as microprocessors have improved control. In the United Kingdom, 75% of lower limb amputations are due to inadequate circulation, often associated with diabetes and heart disease, but there is insufficient evidence to guide prosthetic rehabilitation approaches for these patients. Prostheses are also used in animals, including dogs, cats, pigs, rabbits, and turtles.

Did You Know?

• A transradial prosthesis replaces an arm missing below the elbow and is often called a 'BE' or below elbow prosthesis.
• A transfemoral amputee must use approximately 80% more energy to walk than a person with two whole legs.
• In the prosthetics industry, a transtibial prosthetic leg is referred to as a 'BK' or below the knee prosthesis.
• Wheeled prostheses have been used in the rehabilitation of injured domestic animals such as dogs, cats, pigs, rabbits, and turtles.