Week 7 Flashcards
What are the challenges for partial hand prosthetics?
Little room for components
cosmetically difficult
functionality limited with many designs
What are the different partial hand amputation level classifications?
Transphalangeal: thumb spared
Thenar partial or complete
Transmetacarpal, distal: thumb spared or involved
Transmetacarpal, proximal: Thumb spared or involved
What are the challenges for transphalangeal?
Difficulty holding small objects
Body image
Fine motor like typing can be painful and difficult
Do transphalangeal use a prosthesis?
No, most don’t
What are transphalangeal prosthetic options?
cosmetic Functional non-articulated positional positional with "touch" Active body powered Externally powered
What are the two types of transphalangeal cosmetic prostheses?
Silicone
Vinyl
What are the aspects of the silicone cosmetic prosthesis?
Durable-non staining
realistic
high cost
long turn around
What are the aspects of the vinyl cosmetic prosthesis?
Less durable-stains
mass produced
less expensive
do it in the office
What are the advantages of the trans-phalangeal cosmetic prostheses?
cosmetic
protects residuum
some function: physiologic length, keyboard
What are the disadvantages of the trans-phalangeal cosmetic prostheses?
Less function: no articulation
decreased sensation
less durable: rugged activity destroys
What is the transphalangeal functional prosthesis/
3D printing finger tip-plastic
What are the advantages of the transphalangeal functional 3D prosthesis?
Extremely durable
very inexpensive
What are the disadvantages of the trans-phalangeal functional 3D prosthesis?
less cosmetic
less gripping strength: reduced friction articular surface due to hard material
What are the advantages of the trans-phalangeal functional static opposition post?
Provides opposition
can be made for specific tools
inexpensive
What are the disadvantages of the trans-phalangeal functional static opposition post?
cosmetics
does not allow for multi-positions
What is the trans-phalangeal positional?
Friction joints placed to desired position
cosmetic silicone cover
What are the advantages of the trans-phalangeal positional?
preposition for function
more cosmetic than rigid functional
What are the disadvantages of the trans-phalangeal positional?
no active articulation: limits prehension ability
less cosmetic than passive
What are trans-phalangeal sense of touch?
Friction joints with liquid filled bladder to transmit forces to residuum.
Invented by Leticia Cervantes industrial designer
What are the advantages of the trans-phalangeal sense of touch?
grip feedback
pre-positional
What are the disadvantages of the trans-phalangeal sense of touch?
less cosmetic
no active prehension
What does the trans-phalangeal mechanical work with?
multi-axes capturing and projecting proximal joint motion
What are the three types of trans-phalangeal mechanical prostheses?
x-finger from Didrick Medical
Bio-mechanical Prosthetic Finger (BPF) from RCM Enterprises
M-fingers from liberating technologies
What are the advantages of the trans-phalangeal mechancial?
increased function-due to articulation
can hold different shapes
x-finger: great ROM
BPF: plastic, durable
What are the disadvantages of the trans-phalangeal Mechanical?
less cosmetic
Less durable than static
x-finger: insecure hold, long wait
BPF: decreased ROM
What are the aspects of the M-Fingers?
Whole or partial finger replacement
Body powered: wrist flex-finger flex, wrist extend-finger extend
What are the advantages of the M-fingers?
increased fuction
stronger grip force
more durable
What are the disadvantages of the trans-phalangeal M-fingers?
less cosmetic
increased bulk
increased fabrication time
What are the trans-phalangeal externally powered devices?
Vincent fingers- Vincent systems, shorter-motor in finger itself
ProDigits- touch bionics, too long for finger replacement
What are the advantages of the trans-phalangeal externally powered prostheses?
increased dexterity
increased power
less bulk
high tech look
What are the disadvantages of the trans-phalangeal externally powered prostheses?
can’t go in water
less cosmetic than passive
more bulk than passive
What are the challenges of the Thenar partial or complete?
no opposition for finger grip
more debilitating than finger amputation
fewer functional options
What are the different types of Thenar prostheses?
cosmetic static opposition post cosmetic Static opposition post functional positional thumb Active external powered thumb
What are the advantages of the thenar static opposition post cosmetic?
provides opposition for finger grips
greatly increased function
cosmetic
protects the residuum
What are the disadvantages of the Thenar static opposition post cosmetic?
static opposition-can’t change thumb position
less function than articulated thmbs
custom very expensive
What is the Thenar Static Opposition post functional made of?
Plastic
Wood
Carbon
What are the advantages of the Thenar static opposition post functional?
Simple
low cost
provides opposition
What are the disadvantages of the Thenar Static opposition post functional?
less cosmetic
only one position for opposition
What are the two types of Thenar positional thumbs?
M-finger from liberating technologies
Robin Aides-may no longer be avaliable
What are the advantages of the Thenar positional thumb?
different positions
finger opposition
What are the disadvantages of the Thenar positional thumb?
less cosmetic
cannot-ab/adduct
no active positioning
What is an active external powered thumb?
ProDigits from Touch Bionics
What are the advantages of the Active external powered thumb?
increased dexterity-active positioning
increased power
high tech look
can have cosmetic cover
What are the disadvantages of the active external powered thumb?
cost-no medicare medicaid
cannot go in water
What is trans-carpel proximal or distal?
no fingers or thumb
What are the options for the trans-carpel proximal or distal?
cosmetic static post positional post activity specific wrist driven body powered external powered
What are the advantages of the trans-carpel proximal or distal cosmetic?
most cosmetic
gross motor bi-manual grasp
What are the disadvantages of the trans-carpel proximal or distal cosmetic?
little function
low durability
What are the advantages of the trans-carpal static post/
simple
inexpensive
strong grip determined by force generated with feedback
what are the disadvantages of the trans-carpal static post?
cosmesis
limited grip opening
What are the advantages of the trans-carpal CAPP multi-positional post?
provides opposition
grip strength with feedback
positioned at 30 and 54 degrees
can be folded out of the way
What are the disadvantages of the trans-carpal CAPP multi-positional post?
cosmetics
What are the advantages of the trans-carpal tool specific?
specific tasks
low cost
ease of donning/doffing
with other devices
What are the disadvantages of the trans-carpal tool specific?
cosmetics
What is the trans carpal wrist driven?
custom fabricated with movable wrist section clamps onto thumb
What are the advantages of the trans-carpal wrist driven?
strong grip with feedback
more cosmetic than post
What are the disadvantages of the trans-carpal wrist driven?
cosmesis
fine motor control
What are the advantages of the trans-carpal wrist driven 3D printed?
simple to favricate functional grasp extremely inexpensive parts easily replaced feedback on grip strength
What are the disadvantages of the trans-carpal wrist driven 3D printed?
less cosmetic
less functional than external powered
What are the advantages of the trans-carpal wrist driven M- fingers?
more cosmetic
fine motor prehension
grip strength with feedback
opposable thumb
What are the disadvantages of the trans-carpal wrist driven M-fingers?
cosmesis
bulky
lighter than external power
How do the M- fingers move?
wrist extension=finger extension
wrist flexion= finger flexion
What are the aspects of the trans-carpal body powered VO or VC hook cable operated?
hook mounted in medial palm area
bowden cable
figure 9
operates glenohumeral flexion, biscapular abduction
What are the advantages of the trans-carpal VO VC hook cable operated?
fine prehension
if no wrist movement cable control
What are the disadvantages of the Trans-Carpal VO VC hook cable operated?
cosmesis
harness and cable
bulky
What is the trans-carpal external powered hook?
external powered opening hook
myo or switch control
battery powered
What are the advantages of the trans-carpal eternal powered hook?
ease of opening if weak upper body
fine prehension
What are the disadvantages of the trans-carpal eternal powered hook?
cosmesis
bulky
water intolerant
What are the advantages of the trans-carpal external powered otto bock hand?
shorter base than other standard powered hands standard XP hand covered by most 3rd payer and medicare cosmetic good grip dynamic mode control
What are the disadvantages of the trans-carpal external powered otto bock hand?
only one grip pattern
bulky
less cosmetic than anthropomorphic hands
What are the advantages of the trans-carpal external powered anthropomorphic hands?
multiple grasp options
fine motor
grasps many shapes
ease of operation-myo or switch
What are the disadvantages of the trans-carpal external powered anthropomorphic hands?
expense
water
durability
bulk
What two types of anthropomorphic hands are there?
Vincent finger
ProDigits
What must you keep in mind when dealing with partial hands?
complicated level
many options
creativity with whatever system
multiple optional systems