Conventional Prosthetic Elbows Summary 2
Custom Prosthetic Services Ltd
Description
Collection
Title:
Conventional Prosthetic Elbows Summary 2
Creator:
Custom Prosthetic Services Ltd
Date:
5/6/2009
Text:
Summary 2:
Have you thought about and extension prosthesis with no elbow joint?
This would be a prosthesis with no elbow joint, but fixed in a specific position of elbow flexion, internal rotation and wrist position. Then the lamination could be reinforced for the loads you are describing. It requires careful evaluation perhaps using a current prosthesis with and elbow to find the most universal position that can accommodate these heavy duty activiies. As long as the location of the Terminal Device in space can be moved about using the patients shoulder and Glenohumeral joint, it is surprisingly functional and of course most durable. It does not have to be the anatomical length, but the most functional location of the TD for activities. Shorter is often better than longer, but the TD has to be able to be placed far enough away from the body to heave hay bales or other bulky itmes for example. Careful evaluation of the shoulder extension ROM is necessary, because
carrying heavy things at ones side in the TD will cause the shoulder to be in extension. As a fallback, make sure the proximal part of the laminated frame/extension is adjustable so you can tweak the angle and rotation if it is off a bit If the position is carefully chosen, some patients find it a useful Rx for most of their functional activities, so have fun with this.
For example, I have worked with a wrangler with a fixed elbow to hold the rope and reins while he throws the rope with his other hand. Trunk motion controls the horses reins because he has a Shoulder Disarticulation amputation. He has special QD (Bock) and flexion components in case he falls off the hores or needs to fine tune the angle of the reins to control the horse. It's dimensions are short so they align the TD for reining the horse while sitting in the saddle.
If you really couldn't do this with a fixed elbow, I wouldn't use stock prosthetic components, but go to the hardware store. I can't imagine that you would need to do this though, as usually such active amputees are pretty good at visual spatial application.
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I have not had any experience with the Steeper elbow, however, I cannot imagine it being stronger or more durable than the E-400HD elbows and especially the XHD version!
I had one patient who continually broke the locking teeth of the standard E-400, until we upgraded to the XHD version! Even though they are special order, it is possible Hosmer will have one in stock you can look at and return if you are not pleased with who it looks.
I have done a number of hybrid, Myo Hand/Mechanical Elbow, systems and the E-400HD versions worked the best for high end users in aggressive vocational and/or avocational situations.
My current preference is the OB Ergo Arm, when I can use it but it is not a durable elbow!
Have you thought about and extension prosthesis with no elbow joint?
This would be a prosthesis with no elbow joint, but fixed in a specific position of elbow flexion, internal rotation and wrist position. Then the lamination could be reinforced for the loads you are describing. It requires careful evaluation perhaps using a current prosthesis with and elbow to find the most universal position that can accommodate these heavy duty activiies. As long as the location of the Terminal Device in space can be moved about using the patients shoulder and Glenohumeral joint, it is surprisingly functional and of course most durable. It does not have to be the anatomical length, but the most functional location of the TD for activities. Shorter is often better than longer, but the TD has to be able to be placed far enough away from the body to heave hay bales or other bulky itmes for example. Careful evaluation of the shoulder extension ROM is necessary, because
carrying heavy things at ones side in the TD will cause the shoulder to be in extension. As a fallback, make sure the proximal part of the laminated frame/extension is adjustable so you can tweak the angle and rotation if it is off a bit If the position is carefully chosen, some patients find it a useful Rx for most of their functional activities, so have fun with this.
For example, I have worked with a wrangler with a fixed elbow to hold the rope and reins while he throws the rope with his other hand. Trunk motion controls the horses reins because he has a Shoulder Disarticulation amputation. He has special QD (Bock) and flexion components in case he falls off the hores or needs to fine tune the angle of the reins to control the horse. It's dimensions are short so they align the TD for reining the horse while sitting in the saddle.
If you really couldn't do this with a fixed elbow, I wouldn't use stock prosthetic components, but go to the hardware store. I can't imagine that you would need to do this though, as usually such active amputees are pretty good at visual spatial application.
----------------------------------------------------------------------------------
I have not had any experience with the Steeper elbow, however, I cannot imagine it being stronger or more durable than the E-400HD elbows and especially the XHD version!
I had one patient who continually broke the locking teeth of the standard E-400, until we upgraded to the XHD version! Even though they are special order, it is possible Hosmer will have one in stock you can look at and return if you are not pleased with who it looks.
I have done a number of hybrid, Myo Hand/Mechanical Elbow, systems and the E-400HD versions worked the best for high end users in aggressive vocational and/or avocational situations.
My current preference is the OB Ergo Arm, when I can use it but it is not a durable elbow!
Citation
Custom Prosthetic Services Ltd, “Conventional Prosthetic Elbows Summary 2,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/230113.
