Prosthetics Health Article

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Definition

Prosthetics is the branch of surgery concerned with the replacement of missing body parts with artificial substitutes.

Description

While prosthetics is defined as a branch of surgery, those involved in this profession include the surgeon, nurse, prosthetist, and physical therapist. Others involved in treatment can include a prosthetics technician, prosthetics assistant, rehabilitation counselor, and social worker.

The goal of prosthetics is to replace all or part of a missing limb so that a patient can function. This replacement can involve fitting a man with an artificial leg so that he can walk, or equipping a woman with an artificial hand so that she can hold objects. An artificial appliance is often called a "prosthetic" or a "prosthesis." Prosthesis can also refer to the replacement of a missing part with a prosthetic.

Historical perspective

The practice of prosthesis dates back to ancient times. During the sixteenth century, a German knight was

Guide for preprosthetic evaluation
Item to be evaluated Observe for:
SOURCE: Sanders, G.T. Lower Limb Amputation: A Guide to Rehabilitation. Philadelphia: F.A. Davis Co. 1986.
Activities of daily living Transfers; ambulatory status; home (including hazards and barries); sel-care
Medical status Cause of amputation; associated diseases/symptoms; medications
Neurologic Sensation; neuroma; phantom pain; mental status
Psychological Emotional status; family and work situations; prosthetic goals
Range of motion Hips; knee; ankle
Residuurm length Bone length; soft-issue; redundant-tissue length
Residuurm shape Cylindrical conical, hourglass, "dog-ears", bulbous, above-knee adductor roll
Skin Scar; open lesion; sensation; grafts
Vascularity (both limbs if vascular disease is cause of amputation) Pulses; color; temperature; edema; pain; trophic changes

known as Gotz of the Iron Hand because of his prosthetic. The appliance's movable fingers enabled the knight to hold a sword.

Wood, however, served as the primary material for prosthetics until the twentieth century. In the aftermath of two world wars, research led to the development of prosthetics made of aluminum alloys, metals, and fiber material.

Throughout the centuries, prosthetics were made with mechanical devices and rubber band-type material to allow their wearers to grip objects and move more easily. Movement devices in prosthetics now include hydraulic knees and computer-programmable hands that sense muscle movement.

Legs, arms, feet, and hands are the most commonly known artificial appliances. Other prosthetics include artificial eyes, hip joints, breasts, and heart valves. Prosthodontics is the branch of dentistry concerned with the replacement of teeth.

Contemporary prosthetic care

Patients requiring prosthetic care range from children born with missing limbs to elderly adults requiring hip joint replacement surgery. Such trauma as an automobile accident may cause the loss of a limb, and such conditions as diabetes may lead to the amputation of a limb.

Health care roles

Patients are seen by a prosthetics health care team, which can include a surgeon, nurse, prosthetist, prosthetics technician, prosthetics assistant, and physical therapist.

Prosthetics is sometimes also grouped with orthotics in allied professions. Orthotics is concerned with producing and fitting braces (orthoses) for patients' limbs and spines.

Work settings

Members of the prosthetics health care team work in hospitals, rehabilitation facilities, medical centers, medical schools, colleges, and universities. Prosthetics technicians may work in those settings or in labs and facilities that manufacture prostheses.

The prosthetist designs and fits prostheses. When surgery is planned, the prosthetist consults with the surgeon about where a limb is to be amputated. The prosthetist's input includes recommendations about fitting the prosthesis after surgery.

Pre-operative preparation

For some members of the health care team, patient contact begins before surgery. The doctor examines the patient to determine if more treatment is needed. If amputation is required, those who counsel the patient may include the doctor, nurse, and social worker. They will try to help the patient prepare emotionally and physically for surgery and rehabilitation.

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Author Info: Liz Swain, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
 
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