All prosthetic devices are not equal. Some prosthetic devices are rudimentary and are nothing more than a tool. Depending on the activity sought to undertake, a particular prosthetic device will suffice. Custom activity-specific prostheses are often designed for more vigorous heavy-duty activities. For the legs, it may be a special running, hiking, golf, backpacking, heavy-duty, or even skiing prostheses. We have all seen the specialty legs used by Professional Paralympic Athletes. Since most prostheses are made for everyday use that does not react well to water, special swim, shower, or scuba legs are used. Any prostheses part made of aluminum or steel will corrode when exposed to water. Custom activity-specific water prostheses are designed to withstand prolonged water, sand, and salt exposure. For the upper body, it may be a prosthesis with a fine dexterity hand for gripping or a simple prosthetic to perform manual labor. They are all substitutes. Substitutes to enhance mobility. Substitutes to enhance functionality. Substitutes to improve the ability to perform the activities of daily living.
Central to the success of an amputee’s use of the prostheses is the fit of the socket. The socket must fit properly and securely. A poorly fitted socket will cause pain and often lead to blistering. Without a properly fitting socket, the amputee will never achieve maximum benefit from the prostheses, regardless of technological advancements with the device. Ultimately, the skill of the prosthetist will result in a properly fitting socket. If your socket routinely is not fitting, it is likely not the prosthetic device and it is more than likely the prosthetist. A good prosthetist doesn’t just get a secure fit initially. A good prosthetist has insight and knowledge of the likely changes that will occur with the stump and makes adjustments accordingly.
Understanding the positive impact of high-quality prosthetic devices is central for trial lawyers representing amputees. We are in the early stages of technological prosthetic advancements. New micro-chips, wired pressure sensors in the fingers of artificial hands to sensory nerves in the arm are being developed and tested in private laboratories and universities around the world. Out front on research includes Case Western Reserve University in Cleveland, Ohio, where advanced studies in artificial limbs are ongoing and Massachusetts Institute of Technology. One of the most exciting advancements in recent years happened at the Rehabilitation Institute of Chicago where researchers confirmed that thoughts controlled a prosthetic leg. A patient was able to move from a seated position to standing, and even climb some stairs, solely in response to neurological signals sent from the brain, to the stump, to the prosthetic device. It is called pattern recognition.
The advancements are not limited to legs either. Pattern recognition and sensory feedback have been central to the research being done in research centers in Italy and Switzerland. At the Ecole Polytechnique Federale de Lausanne in Switzerland, scientists have incorporated technology directly into mechanical tendons. By so doing, fingers feel like fingers to the amputee because the wires in the prosthetic connected to the mechanical tendons lead to electrodes on the sensory nerves of the stump. The sensation travels to the brain providing the sensation of a real hand.
Scientists are tapping into a large number of sensory nerves on the stump by innovating sensory connectors that have computer chips within them. It should not be overlooked that no wires penetrate the skin. Rather, computer chips are affixed to the stump through sensors. The sensors and chips have wires leading to the prosthetic. The integration of such advanced prostheses depends on the amputee mastering mental integration. To increase the likelihood of success, most higher-level institutions encourage the amputee to participate in yoga and sometimes meditation. An amputee must be emotionally ready to control the prostheses rather than the prostheses controlling the amputee.
In addition to many Universities, companies like BionX is a leader in the field of prosthetic innovations and is working on developing intuitive prosthetic legs. The company was founded by a Professor at MIT in Boston where he also directs the Center for Extreme Bionics. What may be unique about the founder is that he is also a double leg amputee. He not only creates the most cutting edge bionic legs, but he also uses them daily. Bionic prosthetic with powered propulsion enables amputees to walk farther and faster, normalize their gait so less stress is placed on the joins and they provide confidence in control to walk over uneven surfaces.
Prosthesis’s advancements are not limited to the device itself. Progress has been made regarding the comfort and functionality of the socket. Technology has been created to use computers to measure the stump. Three-dimensional printing is being used to manufacture the socket so it fits perfectly. The materials used in printing are not limited to the socket. Skin coverings made from silicones, gels, and urethanes are being deployed to protect the friction between the stump and the socket.
While much of the work currently is experimental and won’t be readily available for five to ten years, trial lawyers must consider all future alternatives for their clients. As an example, when the i-phone came out, there was the 1.0 version. Then the 2.0 was introduced. After the 2.0, Apple was working on the 3.0, 4.0 and was planning the 5.0. If a trial lawyer argues the amputee should only recover the existing available technology, the amputee will be forever limited. Imagine being limited to the i-phone 5 when the i-phone 8 is released. With the typical life-span for prosthetic devices due to normal wear and tear being 3-5 years, the ability to upgrade into the latest technologies is significantly important for the long term quality of life of the amputee. In addition to a limited life-span for prosthetics, prosthetic sockets generally average a life span of only twelve to twenty-four months. Let’s not forget about all of the liners an amputee uses when using their prosthetic device