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Information for Health Care Professionals
Prosthetic Overview

Paul Murka (Left)
HISTORY
ART
CRAFT
SKILL
EXPERIENCE
SUBJECTIVE
OPINION
MYSTIC
APPRENTICESHIP
SCIENCE
TECHNOLOGY
OBJECTIVE
ENGINEERING
PREDICTABLE
EMPIRACLE
PROCESS
SYSTEMS
LAWS

Qualifications:

  Education Requirements
    American Board for Certification (ABC) in Orthotics & Prosthetics requires:
        1) A Bachelor’s of Science degree
        2) A Postgraduate Certificate of Education in Orthotics and/or Prosthetics
        3) A One Year Clinical Experience Supervised by an ABC Practitioner
        4) After completion of the one year residency, the candidate must pass written and
         practical exams
    Ohio Licensure Requirements
         American Board Certification + Continuing Education

Our facilities meet the requirements of the American Board for Certification by maintaining high standards of technical competence and ethical practice. We are proud to say Fidelity Orthopedic was one of the first facilities in the country to receive this accreditation.

Our Prosthetics Lab
Our Prosthetic Lab

What makes us a different kind of Prosthetic Facility In addition to using the best Central Fabrication facilities available to the prosthetic community we also have two Registered Prosthetic Technicians on staff which allows us the flexibility of fabricating devices at our facility for even quicker turn-around times.
Our lead technician has had almost nineteen years of experience with Fidelity Orthopedic. Our technicians have taken board exams to become “registered technicians” and must complete continuing education hours annually to maintain their status with the American Board for Certification in Prosthetics.

Amputation Facts:

There are about 350,000 amputees living in the US, with about 135,000 new amputations each year.
The peak age for amputations is between 41 and 70 years of age, with 75 percent of all amputations occurring in people over the age of 65.
Amputation rates are higher in males than in females.
African-Americans with diabetes have a 2.3 times greater rate of amputation that Caucasians with diabetes
80% of adult patients with amputations have vascular disease
75% of this group also has diabetes
Congenital limb deficiencies account for about 50% of patients under the age of 15 years old
Acquired amputations in children are usually due to trauma (70%) and cancers (30%)

Amputation Statistics:

In the United States, there are approximately 1.8 million people living with limb loss.
It is estimated that one out of every 200 people in the U.S. has had an amputation.
50,000 new UE amputations every year in USA
Ratio of UE amputations to BE amputations is 1:3.5
  Most common is partial hand amputations with loss of one or more fingers
  Next is loss of one arm - approximately 25,000 annually

Causes Leading to Amputation

Reasons for all amputations Most frequent causes of UPPER LIMB amputations
- cardiovascular disease
 - traumatic accidents
 - infection, tumors
 - nerve injury
 - congenital anomalies
 - Trauma
 - Cancer
 - Vascular
Complications Right arm more frequently involved in work related injuries
UE Amputation Statistics by Cause
Trauma . . . . . . . . . . . . . . . . . . . . . . . . 77%
Congenital . . . . . . . . . . . . . . . . . . . . .  8.9%
Tumor. . . . . . . . . . . . . . . . . . . . . . . . . .8.2%
Disease . . . . . . . . . . . . . . . . . . . . . . . .5.8%
UE Amputation Statistics by Cause
Considerations When Choosing a Prosthesis
  • Expected function of the prosthesis
  • Cognitive function of the patient
  • Vocation of the patient
    - Desk job vs manual labor
  • Avocational interests of the patients
    - Hobbies, Sports
  • Cosmetic importance of the prosthesis
  • Financial resources of the patient
Assessment
  • Patients history
  • Patient Needs and Functional Potential
  • Multidiscipline Plan Based on Team Goals
  • Implementation of Treatment Plan
  • Evaluation of the Plan
  • Discharge

New Goals for UE Prosthetics

  • Give trans-radial amputees full simultaneous control of three wrist functions and at least two hand functions (e.g. implantable electrodes, pattern recognition schemes)
  • Promote investigation of nerve-muscle grafts at the trans-humeral level for control of the elbow and hand/wrist functions
  • Improve suspension methods/alternatives
  • Promote surgical/prosthetic methods to achieve active internalexternal rotation of the forearm by users of trans-humeral prostheses
  • Give shoulder disarticulation amputees a functional shoulder join
  • Improve/promote control methods that incorporate feedback of position, velocity, and force (e.g. body-powered cable systems, and powered E.P.P.-type systems, miniature cineplasty interfaces)
  • Identify power sources with greater energy density
  • Utilize WRAMC as a model to promote team approach to care of persons with arm amputations and to develop outcome measures
  • New components and coverings
  • Surgical interventions

Conclusions

    DEVELOPMENT………is never finished.

    COMPROMISE…………is inherent. The natural hand cannot be replicated with present technology.

    GOAL……………………. the best tools to aid the rehabilitation of people with arm amputations.