Prosthetics and Orthotics

Overview

Prosthetics involves fitting patients with artificial limbs, known as prostheses. Prostheses may be used by individuals with congenital limb deficiency or amputation (loss of an arm, hand, foot or leg). An upper limb prosthesis can improve a patient’s functional activity by providing the ability to grasp or stabilize objects. And a lower limb prosthesis allows individuals the ability to walk to increase their activity level and cardiovascular fitness. Both aim to improve an individual's quality of life. A useful resource to learn more about limb loss or prosthetics is the Amputee Coalition of America (ACA).

An orthosis (also known as a brace) is an orthopedic device that provides stability or correction to a limb or the spine. The overall goal of the orthosis is to increase the patient's ability to function and improve his/her quality of life. Orthoses are designed to meet the biomechanical needs of the patient. Therefore, various orthoses have specific purposes that may include one or more of the following:
  • Maintain or correct body segment alignment
  • Assist joint or resist joint motion during key phases of gait
  • Relieve or distribute distal weight bearing forces
  • Protect from external stimuli - Restore Mobility
  • Minimize risk of deformities
Here are a few examples of diagnoses benefiting from orthoses:
  • Stroke or CVA
  • Cerebral palsy - Spina bifida
  • Long bone malformations
  • Osteogensis imperfecta - Club foot
  • Muscular dystrophy
  • Arthritis
  • Multiple sclerosis
  • Scoliosis
  • Legg-calve-perthes
  • Poliomyelitis
  • Spinal cord injury
  • Fracture
  • Head injuries
  • Muscle, cartilage, tendon rupture
For more information about prosthetics and orthotics please visit our prosthetics and orthotics clinic website.

Procedural Details

Patients must be custom-fit for prostheses and orthotics.

For prosthetics, a patient may be fitted for a temporary prosthesis after a doctor has determined that s/he has adequately healed from limb loss. Several months later, the prosthetist will fit the patient for a permanent, or definitive, prosthesis. A series of measurements of the residual, or remaining, limb will ensure a comfortable fit of the socket, the hollow top part of the prosthesis into which the residual limb will be fitted. The socket must be customized to fit the residual limb exactly so the fabrication and fitting of a definitive prosthesis requires numerous visits and may take several weeks to complete.

For orthotics, the patient will be evaluated to determine the appropriate design to fit his/her needs. Once the ideal design has been determined, the appropriate materials and components will be selected to provide optimum strength, durability and function. The orthotist may obtain an impression of your limb or torso to fabricate a custom molded orthosis, or may modify an off-the-shelf device to custom fit it to your body.

After a prosthesis or orthosis has been fabricated and fit, the patient will receive continuing care, including a periodic evaluation, to ensure the device’s optimal fit and function.

Considerations

Patients who have lost one or multiple limbs should consider being fitted for prostheses after the doctor determines they have adequately healed.  Patients who have a disabling condition that interferes with or could impede on their life activities should consider the option of orthotic devices that may increase the ability to function.

Effectiveness

Prostheses and orthoses may significantly change and improve the lives of patients who have lost a limb or suffered a debilitating injury or disease. The purpose and goals of these devices are to help reduce pain, increase comfort, provide stability, prevent deformity, address aesthetic factors and enhance function and independence.

Risks

Prostheses and orthoses are sophisticated tools with mechanical structures that may break down. In order to work properly, each device needs to fit precisely on patients. Your orthotist/prosthetist will educate you about the care instructions for your device. Growth changes in children and major weight fluctuations will require adjustments to prosthetic and orthotic devices. If you have any questions about your orthosis or prosthesis, please contact your orthotist/prosthetist.