Challenges of High-Level Upper-Limb Absence: Creative Solutions

JOANNA G. PATTON, OTR*Los Angeles, California

Young children who have unilateral or bilateral high-level limb deficiencies or amputations present many challenging and individual prosthetic fitting problems often concerned with comfort, light weight, decreased bulk or good grip force.

Many young amputees who wear endoskeletal shoulder-disarticulation prostheses with laminated sockets complain of heaviness and heat generated in the socket. Prosthetists at the Child Amputee Prosthetics Project (CAPP) fabricate frame sockets which children perceive as lighter, cooler and more comfortable.

Children wearing shoulder-disarticulation prostheses with the Michigan external power system and 1OX hook often complain of limited pinch force. The motor will tolerate only three-quarters to one rubber band. A CAPP prosthetist responded to the problem by adapting the hook with a pulley system which allows use of up to three rubber bands without damaging the motor. Amputees using the adaptation say that the increased grip allows objects to remain securely positioned when pressure or resistance is exerted on the object in the terminal device.

*Child Amputee Prosthetics Project, University of California at Los Angeles, 1000 Veteran Avenue, Los Angeles, CA 90024