Toddler Use of a Switch Controlled Electric Hand Shoulder Disarticulation Prosthesis. A Case Study


CD. is a 21/2 year old with a diagnosis of multiple congenital abnormalities . of bilateral upper extremities resulting in a phocomelic-like right upper extremity with 2 functional digits. The left upper extremity has a shortened humerus, fused elbow, absent. ulna, and 3 functional digits. He was fit with a right passive prosthesis at twelve months of age then, at age 2 he was fit with a shoulder disarticulation socket with a Steeper touch switch that activates a Variety Ability hand using a St. Anthony "cookie crusher" circuit. The elbow has a Liberty Mutual passive friction elbow. To date the combination of a touch switch, electric hand, and circuit has not been attempted. The touch switch failed due to 2 causes: excessive perspiration and heat. In both instances the circuit completed and the hand opened involuntarily. The solution was to replace the touch switch with a mechanical keyboard switch mounted to the original switch box. Within 3 days the patient demonstrated good understanding of the open/close mechanical function and is currently involved with an Occupational Therapy training program.

Shriners Hospital for Crippled Children, 8400 Roosevelt Boulevard, Philadelphia, PA 19152