Below-Elbow Harness Without Axillary Loop

John Hile

M.V.S., a 12-year-old Negro female with a wrist disarticulation type of amputation, was unable to tolerate the conventional figure-eight harness because of skin irritation and lymphaden-opathy in the axilla area.

Originally this problem was solved by the use of a chest strap which was held in place by suspenders over both shoulders. The control cable was attached to the chest strap at about midhumeral level on the lateral chest wall of the amputated side. The triceps pad was modified by adding an epicondyle strap to its lower border (Fig. 1 ). The pad was small and extended up to a point one inch below the level of the chest strap; the reaction point was located 3/4 of an inch below the top border of the pad (Fig. 2 ).

Operation of the terminal device was powered by humeral flexion with the addition of a little abduction. The patient probably used some chest expansion to keep the chest strap from rotating when the terminal device was opened, but she was apparently unaware of this stabilization mechanism.

This method of harnessing worked well until breast development occurred. To meet this situation brassieres were obtained, the elastic straps with fasteners were cut off, and 1-inch dacron tape with a webbing buckle was sewed on (Fig. 3 and 4 ).

To reinforce the brassiere, 1/2-inch dacron tape was attached to the upper and lower borders with a single row of stitching on the outside edges only. No elastic was used (Fig. 3 and 4 ).

The brassiere-type harness worked the same way as the original chest strap with suspenders, but without putting pressure on the breasts, and completely eliminated the original underarm problem.

John Hile is the Clinic Prosthetist Juvenile Amputee Clinic D.C. General Hospital Washington, D.C.