Artificial limb Totally Explained

Everything about Artificial Limbs totally explained

An artificial limb is a type of prosthesis that replaces a missing extremity, such as arms and legs. The type of artificial limb used is determined largely by the extent of an amputation or loss and location of the missing extremity. Artificial limbs may be needed for a variety of reasons, including disease, accidents, and congenital defects. A congenital defect can create the need for an artificial limb when a person is born with a missing or damaged limb. Industrial, vehicular, and war related accidents are the leading cause of amputations in developing areas, such as large portions of Africa. In more developed areas, such as North America and Europe, disease is the leading cause of amputations. Cancer, infection and circulatory disease are the leading diseases that may lead to amputation.

History

An artificial limb is mythologically referred to in the Rigveda, the "iron leg" given to Vishpala by the Ashvins. The first specimen discovered archaeologically, known as the Roman Capua Leg, was found in a tomb in Capua, Italy, dating to 300 BC, and was made of copper and wood. Two artificial toes found on Egyptian mummies are even older, dating to 1295–664 BC; these are being tested (as of July 2007) to determine whether they could have been used in life.

Types

There are four main types of artificial limbs. These include the transtibial, transfemoral, transradial, and transhumeral prostheses. The type of prosthesis depends on what part of the limb is missing.

Transtibial Prosthesis

A transtibial prosthesis is an artificial limb that replaces a leg missing below the knee. Transtibial amputees are usually able to regain normal movement more readily than someone with a transfemoral amputation, due in large part to retaining the knee, which allows for easier movement.

Transfemoral Prosthesis

A transfemoral prosthesis is an artificial limb that replaces a leg missing above the knee. Transfemoral amputees can have a very difficult time regaining normal movement. In general, a transfemoral amputee must use approximately 80% more energy to walk than a person with two whole legs. This is due to the complexities in movement associated with the knee.

Transradial Prosthesis

A transradial prosthesis is an artificial limb that replaces an arm missing below the elbow. Two main types of prosthetics are available. Cable operated limbs work by attaching a harness and cable around the opposite shoulder of the damaged arm. The other form of prosthetics available are myoelectric arms. These work by sensing, via electrodes, when the muscles in the upper arm moves, causing an artificial hand to open or close.

Transhumeral Prosthesis

A transhumeral prosthesis is an artificial limb that replaces an arm missing above the elbow. Transhumeral amputees experience some of the same problems as transfemoral amputees, due to the similar complexities associated with the movement of the elbow. This makes mimicking the correct motion with an artificial limb very difficult.

Current Technology/Manufacturing

In recent years there have been significant advancements in artificial limbs. New plastics and other materials, such as carbon fiber, have allowed artificial limbs to be stronger and lighter, limiting the amount of extra energy necessary to operate the limb. This is especially important for transfemoral amputees. Additional materials have allowed artificial limbs to look much more realistic, which is important to transradial and transhumeral amputees because they're more likely to have the artificial limb exposed.
   In addition to new materials, the use of electronics has become very common in artificial limbs. Myoelectric limbs, which control the limbs by converting muscle movements to electrical signals, have become much more common than cable operated limbs. Myoelectric limbs allow the amputees to more directly control the artificial limb. Computers are also used extensively in the manufacturing of limbs. Computer Aided Design and Computer Aided Manufacturing are often used to assist in the design and manufacture of artificial limbs.
   Most modern artificial limbs are attached to the stump of the amputee by belts and cuffs or by suction. The stump usually fits into a socket on the prosthetic. The socket is custom made to create a better fit between the leg and the artificial limb, which helps reduce wear on the stump. The custom socket is created by taking a plaster cast of the stump and then making a mold from the plaster cast. Newer methods include laser guided measuring which can be input directly to a computer allowing for a more sophisticated design.
   One of the biggest problems with the stump and socket attachment is that there's a large amount of rubbing between the stump and socket. This can be painful and can cause breakdown of tissue.
   Artificial limbs are typically manufactured using the following steps:

Measurement of the stump
Measurement of the body to determine the size required for the artificial limb
Creation of a model of the stump
Formation of thermoplastic sheet around the model of the stump – This is then used to test the fit of the prosthetic
Formation of permanent socket
Formation of plastic parts of the artificial limb – Different methods are used, including vacuum forming and injection molding
Creation of metal parts of the artificial limb using die casting
Assembly of entire limb

Emerging Technology

There are several areas of technology that have advanced significantly in recent years and are showing considerable potential. Robotic limbs and direct bone attachment are two new technologies that have made tremendous gains recently.

Robotic Limbs

Advancements in the processors used in myoelectric arms has allowed for artificial limbs to make gains in fine tuned control of the prosthetic. The Boston Digital Arm is a recent artificial limb that has taken advantage of these more advanced processors. The arm allows movement in five axes and allows the arm to be programmed for a more customized feel.
Targeted muscle reinnervation (TMR) is a technique in which motor nerves which previously controlled muscles on an amputated limb are surgically rerouted such that they reinnervate a small region of a large, intact muscle, such as the pectoralis major. As a result, when a patient thinks about moving the thumb of his missing hand, a small area of muscle on his chest will contract instead. By placing sensors over the reinervated muscle, these contractions can be made to control movement of an appropriate part of the robotic prosthesis.
An emerging variant of this technique is called targeted sensory reinnervation (TSR). This procedure is similar to TMR, except that sensory nerves are surgically rerouted to skin on the chest, rather than motor nerves rerouted to muscle. The patient then feels any sensory stimulus on that area of the chest, such as pressure or temperature, as if it were occurring on the area of the amputated limb which the nerve originally innervated. In the future, artificial limbs could be built with sensors on fingertips or other important areas. When a stimulus, such as pressure or temperature, activated these sensors, an electrical signal would be sent to an actuator, which would produce a similar stimulus on the "rewired" area of chest skin. The user would then feel that stimulus as if it were occurring on an appropriate part of the artificial limb.

Direct Bone Attachment

Direct bone attachment is a new method of attaching the artificial limb to the body. The stump and socket method can cause significant pain in the amputee which is why the direct bone attachment has been explored extensively. The method works by inserting a titanium bolt into the bone at the end of the stump. After several months the bone attaches itself to the titanium bolt and an abutment is attached to the titanium bolt. The abutment extends out of the stump and the artificial limb is then attached to the abutment. Some of the benefits of this method include:

Amputees have better muscle control of the prosthetic.

Amputees can wear the prosthetic for an extended period of time - with the stump and socket method this isn't possible.

Transfemoral amputees are more able to drive a car. The main disadvantage of this method is that amputees with the direct bone attachment can't have large impacts on the limb, such as those experienced during jogging, because of the potential for the bone to break.

Cost

Transradial and transtibial prostheses typically cost between US $6,000 and $8,000. Transfemoral and transhumeral prosthetics cost approximately twice as much with a range of $10,000 to $15,000 and can sometimes reach costs of $35,000. The cost of an artificial limb does recur because artificial limbs are usually replaced every 3-4 years due to wear and tear. In addition, if the artificial limb has fit issues, the limb must be replaced within several months. Jaipur Foot, an artificial limb from Jaipur, India, costs about US$ 40.
There is currently an open Prosthetics design forum known as the "Open Prosthetics Project". The group employs collaborators and volunteers to advance Prosthetics technology while attempting to lower the costs of these necessary devices. Visit their site at http://OpenProsthetics.org.
A plan for a low-cost artificial leg, designed by Sébastien Dubois, featured at the 2007 Indernational Design Exhibition award show in Copenhagen, Denmark. It plans to be able to create an energy-return prosthetic leg for US 8 dollars, composed primarily of fiberglass.

Footnotes

Further Information

Get more info on 'Artificial Limbs'.

External Link Exchanges

Do you know how hard it is to get a link from a large encyclopaedia? Well we're different and will prove it. To get a link from us just add the following HTML to your site on a relevant page:

<a href="http://artificial_limb.totallyexplained.com">Artificial limb Totally Explained</a>

Then simply click through this link from your web page. Our crawlers will verify your link, extract the title of your web page and instantly add a link back to it. If you like you can remove the words Totally Explained and embed the link in article text.
As long as your link remains in place, we'll keep our link to you right here. Please play fair - our crawlers are watching. Your site must be closely related to this one's topic. Any kind of spamming, dubious practises or removing the link will result in your link from us being dropped and, potentially, your whole site being banned.