LOCAL LAB PRODUCES ARTIFICIAL LIMBS

Many years ago, those persons who lost limbs due to accidents or amputation had to either rely on burdensome wooden limbs or adjust to life with a missing body component.

Today, due to progress in the field of science, options are available to make daily living easier for those who have suffered the loss of a limb.

Prosthetics is the branch of medicine that supplies artificial parts for the body.

A prosthesis is an artificial replacement that replaces a missing body part or a device designed to improve body function. Prostheses include artificial limbs, false teeth, hearing aids, artificial kidneys and implanted pacemakers.

In Cape Girardeau, Cape Prosthetics-Orthotics Inc. is the only facility between St. Louis and Memphis that produces artificial limbs. Delbert Cobb, certified prosthetist and owner of the facility, explained that his lab supplies both upper- and lower-extremity prostheses. He and Kenneth E. Fulton are certified prosthetists and are nationally certified to evaluate, measure and fit prostheses.

To become nationally certified, one must have a college degree in any subject, followed by a one-year prosthetic program and a one-year internship in the field. After successfully passing the certification exam, the prosthetist is certified to work anywhere in the United States.

Cobb explained the process that a patient goes through to be provided with a prosthetic device. The patient is first evaluated. An attempt is made to match the site of amputation and activities to the patient's goals. This is done through measurement ofthe patient using calipers and plaster impression of the residual limb.

A negative mold is taken, filled and adjusted according to the style of prosthesis selected. The prosthesis is fabricated and put in a static alignment.

The patient is brought back in for a dynamic alignment.

"He is taken through range of motion from sitting to standing to walking to make sure the prosthesis doesn't impinge on the body," explained Cobb. "We try to get as normal a gait as possible with the least discomfort."

The process from evaluation to fitting usually takes three weeks.

Cobb said the body changes over time, and this causes the prosthesis to need adjustment. "It is always an on-going adjustment," he said. "To work best, the prosthesis needs maintenance and follow-up like a car does. If you take care of your car and maintain it, it will work longer and better."

Most prosthetic devices are quite complicated. The most sophisticated is the Utah arm, which is electrically controlled. The wrist, elbow and hand are activated by electrodes placed on the body. Electronic components available today are utilized.

Electronics for the knee aren't readily available at this time. The prosthetic knee is operated mechanically or fluid controlled.

The devices are attached through suction, by clamping the prosthetic over a bony prominence, or by some type of strap.

The space race has had an impact on the prosthetic industry. Many of the devices today are made of aerospace by-products, such as carbon fiber, epoxies, Kevlar and fiberglass. Before, many constructed were made of laminates, polyester resin and nylon.

It is important that the prosthetic be kept as light as possible, because suspension is no longer connective tissue and bone. Therefore, the devices feel heavier than they actually are.

Due to the constant research in the industry, Cobb and his employees must work hard to stay up to date on new devices. "We have continuing education requirements which are required by our national American Board for Certification in Prosthetics and Orthotics Inc.," he said. "We attend national seminars with scientific sessions. Suppliers that sell components have booths to show us how new products can be used. New methods are given in papers at scientific sessions and seminars."

Recent improvements have included lighter materials, more realistic appearance and greater flexibility, which allow a more normal continuation of daily activities.

Cape Prosthetics-Orthotics also is involved in orthotics, which is the science that deals with the use of specialized mechanical devices to support or supplement weakened or abnorrnal joints or limbs. Employee Steven T. Griffith is a certified orthotist.

"Primarily we make custom braces," Cobb explained. "This could involve stroke patients who have loss of muscle control. It could also involve fractures or ruptures. We try to immobilize the patient to prevent further damage and to make the body part as functional as possible."

After employees at the facility have constructed and fitted devices on patients and made sure the devices are properly aligned, the patients are transferred to therapy sessions. Those with a higher level of amputation and more sophisticated prostheses require more sessions.

"We made a prosthesis for a below-the-elbow amputee who had a very short residual limb," Cobb said. He went in for therapy to learn to use his new prosthesis, and the therapist asked him if he could open his hook. His wife threw a Nerf football to him, and he caught it on the first try. Needless to say, this was his first and last therapy session."