Definition and Overview
A prosthesis is a medical device designed to substitute or replace a particular body part to help patients regain certain functions after a body part has been severely injured due to an accident or disease.
In the medical setting, health providers are trained to preserve every part of the body as much as possible. However, there are cases wherein the damage can lead to worse complications such as death, making the process of removing the affected body part a better option. While organs such as the gallbladder or appendix may be taken away without any reduction in quality of life, it’s not the same thing with other body parts such as the legs, bones, eyes, and arms. To ensure they can still be in working condition, prostheses are used.
Prostheses come in different sizes, shapes, and functions. Some prostheses are mainly for cosmetic. These include silicone inserted into the breasts or hands. They may improve the shape, but they may not make the body part as functional as they were before.
Most prostheses are used to preserve or bring back function. The most popular are the arm and leg prostheses. In arm prostheses, the prosthesis may include the hands and the lower arm (transradial) or the upper arm (transmural), which is recommended when the joint of the elbow is missing or have to be removed.
A prosthesis is called transtibial when it replaces any body part below the knee such as the foot. However, if it covers the knee and is connected to the thigh, it’s referred to as transfemoral.
Prostheses may be removable or permanent. Those that are placed inside the body such as artificial hips are considered permanent. While most prostheses are composed of sockets, shafts, and components to mimic the attachment of the limb to a ball and socket or joint, some use cables to attach the prostheses to the body.
Over the years, there have been significant improvements and studies on how to enhance the design of prostheses. In fact, some patients have already been fitted with robotic arms with electrodes connecting to certain nerves of the brain for a more natural control.
Who Needs It and Expected Results
Amputation remains to be one of the leading reasons why prosthetics are used. According to Amputee Coalition, more than 2 million people in the United States have experienced limb loss, and over 180,000 amputations are performed in the country every year.
The coalition also revealed that most of the cases of limb loss are due to diseases that affect the nerves of the limbs such as diabetes and cardiovascular disorder. Meanwhile, about 45% is caused by trauma like vehicular accidents, falls, and violence. Only 2% is caused by cancer.
Patients who have been diagnosed with osteoporosis, a disease that causes the bones to be brittle, may need prostheses later on. The disease causes at least 8 million fractures every year. Around 80% of them occur in the forearm. The others are in the femur, spine, and humerus.
The expected results can significantly vary. Some patients avoid prostheses entirely. On the other hand, physical and occupational therapists often recommend the use of prostheses. During rehabilitation, the patient will be taught how to regain mobility with the new artificial body part and care for the prostheses.
Usually, prostheses can be integrated into the body as early as two weeks following an operation or amputation.
How Does the Procedure Work?
Wearing prostheses is not mandatory, so patients will always have the option to say no. However, many doctors highly recommend them to allow their patients to get back to their normal activities after amputation.
A prosthetist is the one responsible for designing, measuring, and fitting the prostheses. He works closely with the doctor and the patient to determine the best type of prosthesis for patients based on their unique circumstances.
A few days after the amputation, the designing begins. The prosthetist normally measures the length of the stump then compares it to the dimensions of the remaining healthy limb. He also uses imaging results from X-rays, CAT, and MRI scans.
Once the measurements have been taken, he will create a mold of the prostheses using a plaster. It may take a few weeks before the prostheses are completed, although some hospitals have pre-made ones, and only fitting is needed.
During the fitting, the prostheses are connected to the stump and are then arranged and aligned until they fit perfectly. In some cases, several adjustments will be made to achieve this. The patient can then begin with the rehabilitation.
Possible Risks and Complications
Prostheses usually don’t have any serious risks or complications. However, there may be a great deal of pain and discomfort during the first few weeks, especially for the lower limbs. This is because apart from the wound, the patient is forced to carry the rest of the upper body weight.