Clinical Experience with a New Electromechanical Elbow for the Preschool Child

S. HUBBARD, 1. AL-TEMEN, M. MIFSUD,W. F SAUTER, S. NAUMANN, AND M. MILNER


Successful provision of myoelectric prostheses for young below-elbow amputees has led to a similar demand for the above-elbow patient. Development of the Variety Village 2-6 year hand and the new Variety Village 0-3 year hand has made it feasible to fit children as young as 15 months old. Myoprosthetic function for the above-elbow level has been compromised by lack of a suitable elbow. A case presentation illustrates problems in fitting a standard passive elbow and the subsequent development of a new Variety Village miniature electromechanical elbow.

A 22 month old girt with congenital long transhismeral amputation was fitted myoelectrically in May 1985 with a Variety Village three-state system used to control the 2-6 year hand. A modified Otto Bock passive shoulder was incorporated as the elbow, because of the length of the amputation limb. Although she could operate the hand effectively, she quickly became frustrated with the need to position the passive elbow manually. Subsequently, she made little functional use of the prosthesis, only wearing it for its cosmetic value. The first prototype of the new elbow was fitted to the child at 4 years 4 months of age in October 1987. Parents report she is progressing well.

Hugh McMillan Medical Centre, 350 Rumsey Road, Toronto, Ontario M4G 1R8