Lower Limb Prosthetic Devices

Coping with missing and amputated limbs has been a problem for as long as humans have existed. References to prosthetic devices have been found in Indian literature, Greek mythology, Aztec and Inca pottery and myths, Roman texts, and Viking stories.[1] Even with the long-standing history of prosthetics, few major advances have occurred as impactful as the recent utilization of biotechnology to make prosthetic devices more useful, comfortable, and aesthetically pleasing. The Seattle Foot, built by the Model & Instrument Works, Inc based out of Seattle, has revolutionized lower-limb prosthetic devices more than any invention in the history of lower-limb replacement with customer satisfaction and innovative technology.[2]

Historically, prosthetists and physicians did not make prosthetic devices according to the needs of the wearers. However, with advancements in materials, attachment methods, government funding, and medical research, prosthetic limbs can be fit more to the needs and desires of the amputees.[3] Also, unlike prescriptions to medicines, prescriptions for prosthetics require input and satisfaction from the amputee. The large influence of the amputee increases research before, during, and after manufacture by the companies that produce them, public and private organizations, and medical professionals.[4] The National Research Council Advisory Committee on Artificial Limbs claim, “An established, widely accepted criterion,” that a prosthetic device must have are, “a normal external shape and appearance and must permit the amputee to walk comfortably and safely at normal rates on level ground, without undue mental or physical effort and with a normal-appearing gait.”[5] In addition, the amputee must feel confident the prosthetic can carry weight and recover from a stumble without falling. Basically, amputees prefer lower-limb prosthetics that allow them to be independent and appear as if they have their missing limb.

It is clear that war is a catalyst for technological innovation, especially in the medical field. Although the materials used in prosthetics remained basically the same: wood, metal, leather, rubber (when it was available), all held together with a series of hinges and bolts. The Civil War largely affected the number of amputees in America. In 1865, Mississippi government had to spend one fifth of its annual income on prosthetic limbs.[6] The first and second World War saw a great amount of technology transfer and increased infrastructure from war-torn Europe to the United States. Mass production and improvements in prosthetic technology aided veterans and soldiers in the United States and all over Europe to meet demand. Sadly, the devices made for the veterans were not much different than the prosthetics in the Civil War. They still did not address most of the needs of the amputees and it was only around the end of the Second World War when citizens became aware of this.[7]

[1] Oliver Gutfleisch, “Peg Legs and Bionic Limbs: The Development of Lower Extremity Prosthetics,” Interdiciplinary Science Reviews 28, (2003): 139.

[2] A. Bennett Wilson Jr., Limb Prosthetics, 6 ed. (New York: Domos Publications, 1989), 4.

[3] Joan E. Edelstein, “Prosthetic Feet: State of the Art,” Physical Therapy 68, no. 12 (December 1988): 1874.

[4] Paul Klopsteg, et al, Human Limbs and Their Substitutes, (New York: McGraw-Hill Book Company, Inc., 1954) 163.

[5] Paul Klopsteg, et al, Human Limbs and Their Substitutes, (New York: McGraw-Hill Book Company, Inc., 1954) 481.

[6] Oliver Gutfleisch, “Peg Legs and Bionic Limbs: The Development of Lower Extremity Prosthetics,” Interdiciplinary Science Reviews 28, (2003): 141.

[7] Oliver Gutfleisch, “Peg Legs and Bionic Limbs: The Development of Lower Extremity Prosthetics,” Interdiciplinary Science Reviews 28, (2003): 141.

Figure: Kim M. Norton, “A Brief History of Prosthetics,” In Motion 17, no. 7 (November/ December 2007), http://www.amputee-coalition.org/inmotio… (accessed March 15, 2009).