UPPER LIMB PROSTHETICS
 

There are three main types of upper limb prosthetic fittings: body-powered, myoelectric and hybrid, which is a combination of the other two.

Body-powered systems use a harness with cables to move the prosthesis. By engaging larger muscles, the cables can open and close a hook or hand, as well as an elbow or shoulder joint.

With myoelectric systems, the prosthesis actually takes advantage of the natural signals that your muscles generate when they are used. Small sensors, known as electrodes, measure and amplify these muscle (or ‘myoelectric’) signals and are used to activate various functions of the prosthesis, such as opening or closing the hand. Batteries are used to power the motors that make these movements.

Hybrid systems take advantage of both systems. A hybrid system may have a myoelectrically controlled hand and wrist, with a body-powered elbow joint.

Each system has its own advantages and disadvantages. Myoelectic systems have the advantage of using the remnant muscles originally used, for example, for opening and closing the hand, while body-powered systems have to use muscle groups that were not originally intended for those actions. Myoelectric systems may also look more cosmetic, with that trade-off that it may not be as rugged as a body-powered system.

With the aid of pressure applied to the residual limb over a large surface area, swelling (edema) of the residual limb can be reduced and the residual limb can be formed for the future prosthetic fitting. This compression of the residual limb contributes to being able to do your prosthetic fitting as soon as possible and to making it easier to adjust your prosthesis. In addition, compression aids circulation in the residual limb. This reduces the amount of pain and results in improved healing of the scar. Various techniques are used for compression therapy: The residual limb may be wrapped with an elastic bandage, or compression socks or a prefabricated silicone liner may be worn.

Elastic bandages are applied using a special wrapping technique after the wound bandage or residual limb cast, is removed. During the first few days and weeks after the operation, your residual limb will be bandaged by your therapist or by the nursing staff. This somewhat elaborate compression involving elastic bandages can be customized to your individual residual limb amputation level.

You’ll be fit with your new prosthesis once your residual limb has healed and has stabilized in its size. This usually takes from four to six weeks after the surgery.
During your first fitting visit with your prosthetic team, they will make a cast of your residual limb with plaster so that they have an exact replica of your limb. This will be used to make a test socket. The test socket is an interim socket that allows your team to customize the fit of your prosthesis and is generally made from a clear thermoplastic. The material is easily reformed to get an intimate fit, and, because it is transparent, shows where your skin is coming in contact with the socket.

Socket fit is very important. Think of it as a shoe: if it doesn’t fit well, you can’t walk well; no matter how many socks you wear. Once the socket as been customized for your unique anatomy, a definitive socket will be fabricated from lightweight thermoplastic or carbon fiber. The prosthetic components are then attached to this socket.

The goal of rehabilitation training with a physical therapist is to help you gain as much mobility and independence as possible.
Your therapist will help you learn how to use and care for your prosthesis properly, including how to put the prosthesis on and taking it off. Then you’ll begin controls training, repetitive drills, and finally, Activities of Daily Living (ADLs).

Thanks to constantly advancing technology, the latest prosthetic systems feature astonishing capabilities. With expert recommendations from our team you will be provided with relevant components and systems to match individualized goals; with considerations in prosthetic design, functional training, programming, and adaptive equipment