Notes From The Prosthetics Research Program

This article continues the series of abstracts from reports issued by research laboratories in the United States and Canada. The material which follows has been abstracted from the January 1-June 30, 1967, Progress Report of the Prosthetics and Orthotics Research and Development Unit, Sanatorium Board of Manitoba, Winnipeg, Manitoba, Canada (James Foort, Project Director).

- Editor

General

A number of projects for this year are progressing well, but especially gratifying are the good results we are having with the pylon prosthesis system for shank, amputees. Approximately 80 amputees are now wearing them as permanent prostheses. The majority of these cases are geriatrics, who make up over half the clinical load.

The following points are worth noting:

  1. It takes from 2-1/2 to 4 hours to fit, align, and finish this type of prosthesis.

  2. Postfitting socket replacements can be quickly and easily made.

  3. Realignment, length adjustment, or component replacement can be quickly and easily carried out at any time.

  4. Weight of the finished prosthesis-3 to 3-1/2 pounds-is comparable to the lighter standard PTB prostheses.

  5. Parts can be salvaged for reuse.

  6. In our area, the cost of the limb to the amputee or agency has dropped to less than half that of the standard PTB prosthesis.

Local manufacturers who make the metallic components and the cosmetic covers are delivering their products promptly. Quality is excellent. Expansion of production to meet any increased demand is confidently assured.

Future efforts of the research group which relate to this project will be directed toward long-term improvements. We want a greater variety of cosmetic cover shapes available, the SACH foot redesigned for functional and cosmetic improvements, and a simple system which will permit quick conversion of the limb to a joint-corset type. Meanwhile, we will continue to give instructions to prosthetists on how to use the system as it stands. Otherwise, this project is complete. (See the manual, "A Pylon Prosthesis System for Shank (BK) Amputees,"Report No. 6, November 1965, Prosthetics and Orthotics Research and Development Unit, Sanatorium Board of Manitoba, 800 Sherbrook Street, Winnipeg, Manitoba, Canada.)

Summary of Technical Projects

  1. Molds for Series I cosmetic covers of flexible polyurethane for shank pylon prostheses have been completed and are in routine use by the manufacturer.

  2. New telemetering equipment and recorder for use in the electronic alignment studies have arrived from the University of New Brunswick.

  3. Myoelectric studies on the pretibial muscles of shank amputees have been completed.

  4. Foot design has progressed to the point where new aluminum keels are ready for evaluation, some foot shapes have been refined to help solve functional and cosmetic problems, and some foot molds have been made.

  5. A keel for the Syme's foot has been designed which will permit length adjustment, adjustment of alignment, and replacement of the socket.

  6. Clinical tests of the Winnipeg knee-shank unit in permanent prostheses for above-knee amputees continue.

  7. Hosmer-produced Berkeley pneumatic swing-phase-control units continue to function satisfactorily after about a year.

  8. One of the DUPACO units gave up after four months, but the other is going strong after ten months. The failure may be due to our frame.

  9. Mark I and II flexion limiters have been designed for use in the Winnipeg knee-shank unit as a safety feature for feeble amputees.

  10. Eleven immediate postoperative fittings have been done so far.

  11. The series of "instant sockets" for shank (BK) amputees has been completed, and tests have been carried out on 24 amputees so far.

  12. A cable shortener has been designed for use on high-level arm amputees' prostheses where more excursion is needed.

  13. A Toronto electric hook is being put onto a prosthesis for a fore-quarter amputee.

  14. A Simpson CO2-powered arm has been fitted to a thalidomide child, and evaluation of the device is continuing.

  15. Work continues on the powered cart for a thalidomide child.

  16. A UCLA functional long-leg brace has been tried on a marginal case.

  17. Prefabricated receptacles for shank-amputee pylon prostheses have been improved.

  18. Remote fitting studies have been resumed.