Prosthetic Limb Technology
Probably one of the most feared events for anyone is the thought of losing a limb. Unfortunately, today, despite medicine’s best interventions, limb loss is still a reality. Limb loss can result from many causes. Diabetes, peripheral vascular disease and trauma are the most common causes. For most patients when limb loss is inevitable, or where a sudden trauma occurs, the question on the victim and their loved one’s minds is:
Is there life after amputation?
An amputee today has myriad solutions available for prosthetic limb replacement. Losing a limb is much the same as losing a loved one. Amputees will go through a similar mourning and recovery process. Our first priority as Prosthetist is to ensure that the patient has all aspects of his / her amputation considered. This often means that prosthetic rehabilitation starts long before the actual prosthesis is discussed, or designed. Once the amputee has come to terms with limb loss, the physical rehab can get underway.
There are many choices available to an amputee regarding selection of components (prosthetic feet, knee’s and upper limb designs). The internet has opened up a whole world of information …. or misinformation, and is more often than not, misguiding. Unlike other creature comforts in life such a choosing a car or a TV, prosthetics is infinitely more complex. What works for one individual may not necessarily be suitable for the next person. Expert guidance and information is essential when deciding what the most suitable prosthetic solution will be.
Our job as Prosthetists is to carefully assess and guide a patient with regard to pre-prosthesis care and definitive prosthetic design. Each patient is different and has different needs and requirements. Furthermore, amputees might aspire to achieving goals and objective or challenges which they either did not do before the amputation, or which they aspire to do following amputation and successful prosthetic rehabilitation.
In some cases, where patients have a threatened limb due to chronic disease such as a long bone tumour, severe infection in a limb or vascular complications, their surgeon may advise them that an amputation may be imminent – within days or weeks. As the patient will have obvious difficulty in coming to terms with this prospect, it is helpful for that patient to speak to a prosthetist before the surgery about what will happen during and after the amputation. This gives many patients hope knowing that there is immediate intervention available to them. It also helps dispel many myths or misinformation gathered of the internet, or offered by well-meaning but unknowledgeable friends or relatives.
As prosthetists we are not only able to give valuable advice but often consult with the surgeon concerned about what the best amputation type will be best for the patient’s prosthetic rehabilitation. We often attend theatre with the patient and surgeon to offer advice during the surgery regarding which structures should be removed or which technique will allow for the best prosthetic component choices for the amputee. One of the prosthetists nightmares is having to deal with a badly amputated stump – this can significantly limit the prosthetic options available to the patient.
Making sure you get the best treatment and advice:
Specialised paediatric and high-performance prosthetics.
Our approach to paediatric prosthetic care centres on the idea that no two children are alike. Each one has a different story, and we honour that in the way we care for our youngest patients. We strive to understand their unique physical, emotional, and social needs, so we can design the right solution to fit their life.
Upper & lower limb (body powered and micro-processor controlled)
Upper and lower limb body powered prosthesis goes beyond restoring physical movement. Having the right prosthesis is also important in social life, communication, and performing tasks at home and on the job. For people who need a rugged primary or secondary prosthesis, body-powered solutions often provide the right balance of performance and convenience.
Microprocessors can be utilised in both upper and lower limb prosthesis. For instance in an upper body artificial hand, microprocessors can send a signal to the hand to perform a certain movement based on how the person flexes certain muscles in his residual limb.
Partial hand/foot prosthetics
We design prostheses for clients with finger, hand, arm, as well as toe and foot deficiencies. Every prosthesis is custom painted to match the features which are unique to each client. With us, clients receive the most realistic, aesthetic, and functional passive restoration available.
Congenital limb deficiency prosthetics
The overall goal for treatment is to give your child a limb that works and looks right.
There is no standard treatment for a congenital limb defect. Treatment choices may include:
• Artificial limbs (prosthetics)
• Splints or braces (orthotics)
• Rehabilitation, such as physical or occupational therapy
Most frequent questions and answers
Phantom limb pain refers to mild to extreme pain felt in the area where a limb has been amputated. Phantom limb sensations usually will disappear or decrease over time.
Although the limb is no longer there, the nerve endings at the site of the amputation continue to send pain signals to the brain that make the brain think the limb is still there. Sometimes, the brain memory of pain is retained and is interpreted as pain, regardless of signals from injured nerves. Many amputee’s even report ‘still feeling their toes or part of the foot’ (itching/burning/numbness).
Because it is not fully understood whether the phantom pain is real or imaginary, there are several approaches. Medication to reduce nerve pain/conduction may be prescribed. Massage technique (taught by a Prosthetist or Physiotherapist is useful for loosening up tight tissue structures where the muscles have been stitched to each other, or to the remaining bone) . In clinical practice, our experience has been that the most effective way of managing phantom limb pain, is to begin ‘stump coning’ (a special bandage is applied to the stump in a specific way to change the shape of the stump to prepare it for a prosthetic fitting.) It is thought that the circumferential pressure of the bandage improves bio-feedback and reduces phantom pain quite rapidly. Usually, once a prosthesis has been fitted, most phantom pain disappears – because the stump is now in ‘contact’ with the ground and bio-feedback is restored to the brain.
A Neuroma may also have developed in the stump. This is a physiological response following either the amputation, or from the trauma which caused the amputation. This neuroma may need to be surgically removed.
With today’s technology and the advanced research done by prosthetic manufacturers a tailor made solution can be recommended for an amputee. Several research based systems exist where data such as weight/activity levels/ and individual requirements is collated and the perfectly matched solution is recommended. Prosthetics is NOT simply about the components however – the secret is the interface between the stump and the rest of the prosthesis (called the socket). The socket design is the single most important component of a prosthesis. It is like the foundation of a house – you can have the most beautiful finishes in the house, but if the foundation is not stable, the house will collapse. Prosthetics is no different. Patients may easily be confused or misled by “internet searches”. We use the very latest socket moulding and manufacturing equipment available, to ensure perfect fit of the socket.