Everything You Should Know About Custom Prosthetic Devices

May 30, 2020
April 8, 2022

A custom prosthetic device can help you get back to what you love doing most. However, if you’re a new amputee or someone who is choosing a prosthesis for the first time, it’s important to always do your research. Understanding which providers will work best and what goes into custom prosthetics can help you determine your next steps.

Our clinical staff at Horizon Orthotic & Prosthetic Experience understands the importance of a well-fitting, high-quality prosthetic device. For that reason, we provide the best care and devices that are delicately tailored to fit each patient’s unique needs. We believe that the key to custom prosthetics is just that—custom. No two patients should receive the exact same thing.

To learn more about custom prosthetics, keep reading and our experts will lay out the information you need to prepare.

What is a custom prosthetic device?

A custom prosthetic device is a medical device that suspends onto the residual limb. Once properly suspended, it enables a patient to move more efficiently by replacing a certain body part. While there are some prosthetic devices that are only utilized for cosmetic reasons, we will focus on the devices that act as an artificial limb to restore mobility and function.

Patients who want or require a custom prosthetic limb may have been born without a limb or have had an amputation due to disease or injury. No matter the cause, your provider should design your device with your needs in mind. That means taking time to perform careful (and precise) measurements, determining the right suspension method, creating a custom socket, and more. The idea is that your prosthesis fits you perfectly so that it helps you throughout your daily life.

A custom device consists of different structural components, including the:

Socket: The socket is a custom built structure that fits intimately around your residual limb and protects the limb from skin breakdown. It is designed to maximize comfort, control, and proprioception in the device.

Interface: The interface acts as a barrier between the residual limb and the prosthesis. Typically interfaces come in the form of gel cushions or prosthetic socks.

Suspension system: The suspension system is designed to keep your prosthetic attached to your residual limb. The suspension of the prosthesis is very critical to maximizing the comfort, control and proprioception of the device.

Cosmetic cover: Cosmetic covers help to improve the appearance of a device to make it look more natural. In addition, these covers can help to protect the internal components from damage potentially caused by rain, dirt and debris.

What designs of custom prosthetics are available?

Your provider will consider your personal needs before helping you choose the right type of custom prosthetic design. A prosthesis is defined as, “An artificial body part, such as a leg, heart or joint implant.” There are permanent options (one’s placed inside your body); however, those options aren’t meant for limb amputees. Our clinical staff does not provide the internal prosthetic devices. We specialize in limb replacements. Limb amputees receive removable prosthetics, and the most common are arm prosthetics and leg prosthetics.

Arm prosthetics

Arm prosthetics improve the functionality of the arm and hand, allowing movements such as grabbing, reaching, and eating. A lot of patients choose to get an arm prosthesis to get back to their jobs. For example, a writer or painter can return to their jobs once they get used to working with the device.

Within this category there are two common types of prosthetic devices. The choice depends on the type of amputation (below the elbow or above the elbow).

Transradial arm prosthetics

A transradial prosthesis replaces the arm from below the elbow (includes the hand). This is for an amputation through the radius and ulna bones (forearm). Based on your needs, you and your provider can discuss which transradial prosthetic design would benefit you most. The two main options you can choose from include:

  1. Cable-operated: With cable-operated prosthetics, a harness and cable are attached around the opposite shoulder of the residual limb. This is a very durable and functional device that is mechanically driven.
  2. Myoelectric: Myoelectric prosthetics use electrodes to sense when the muscles in the upper arm move. This causes the artificial hand to open and close. This is an electrically driven device that often requires no cable systems.

Transhumeral arm prosthetics

A transhumeral prosthesis replaces the arm from above the elbow but below the shoulder.  This is for an amputation through the humerus bone (upper arm). Keep in mind that these devices are more difficult to build. Think of it this way. The elbow joint can flex (bending the arm toward the elbow), extend (stretching the arm out), and rotate (twisting the arm back and forth). That is a lot of movement for one joint. Because of this, replicating the complexities of the elbow requires extreme care and years of experience.

Leg prosthetics

A lower extremity prosthesis is designed to help patients with an amputation of the leg to restore their functionality. The largest benefit comes from the ability to walk. For many people, walking on their own is key to making the most out of their lives. That independence may be the difference between a positive outlook and a negative one.

Not only can patients gain walking ability, depending on the prosthetic device, many patients excel to the point where they can also ride a bike, swim, run, and participate in sports.

Similar to arm prosthetics, the design and build of a custom leg prosthetic depends on whether the amputation is above the knee or below.

Transtibial prosthetics

A transtibial prosthesis or below-knee prosthetics is for an amputation through the tibia and fibula (lower leg). Since these patients still have their anatomical knee, it makes adapting to walking with a prosthesis much easier. It also means that patients tend to regain full functionality more quickly than someone who does not have a knee joint.

Transfemoral prosthetics

A transfemoral prosthesis or above-knee prosthetics is for an amputation through the femur bone (thigh). In this case, a patient no longer has the knee joint, making the design and build of the device more difficult. However, the clinical staff at HOPE has the most advanced technology available today.  This technology includes incorporating computer chips into the mechanical knee joint to process what is happening while walking.  These advancements have dramatically improved the functional capabilities of individuals with a transfemoral amputation.

How are custom prosthetic devices made?

The process begins with a consultation. When you go in for a consultation, your prosthetist at HOPE will speak with you about your needs and goals. There are a lot of factors that the clinician must consider before making recommendations on which prosthetic device will best suit you.

Due to the meticulous nature of prosthetic design, the process could take several weeks from start to finish. However, you shouldn’t let that deter you. The only way a prosthetic device will work is with a commitment from all members of the rehab team to an outcome that restores the functional abilities of the amputee.

To give you an example of what to expect, here is the step-by-step process we use at HOPE KC.

Step One: Preliminary evaluation and measurements

Our process begins with a conversation to evaluate your needs. We want to understand what is important for you and what will help you move forward in life. Our biggest concern is your goals and what is stopping you from reaching them.

After that evaluation, we begin taking a series measurements of your residual limb and your sound side limb. This allows us to compare your normal anatomic structure to create a device that will best match that.

Step Two: Casting the limb

From the measurements, we then cast your limb to create the perfect fit. Depending on the situation, you limb may be hand cast using plaster or scanned by a 3D scan. As a result, this allows us to build a device that will give you the most comfort and mobility.

Step Three: Creating a diagnostic socket

The socket is arguably one of the most important parts of the overall prosthetic system. Without a properly fitting socket, it is likely that the device will not even get worn. An improperly fitted device can even lead to irritation and pain in the residual limb.

For that reason, we typically start with a clear test (or diagnostic) socket before creating the definitive socket. The test socket enables us to see pressure points and how the socket interacts with your limb. This is a process that includes multiple adjustments and improvements until the ideal socket is designed. In some cases, the socket fit is ideal on the first test fitting. This allows us to move forward with fabricating the definitive socket much sooner. In other instances, the socket may not be optimal, and we will create a different one until one fits.

Step Four: Delivery and final fitting

Once we’ve settled on the right socket fit and built your custom prosthetic device, we will have one final appointment with you to fit the device.  During this delivery process we will carefully examine the fit, function and suspension of the device to insure that we are providing the maximum functional outcomes. If you are a new amputee or new to prosthetics, this process may take longer than someone who is more accustomed to fittings. Our expert staff will go over the entire process of donning, doffing, care and precautions to ensure that you fully understand how to safely and successfully utilize the new prosthetic device.

Since our patients are our number one priority, we take extra time and care to help them understand how to use their device and the best ways to maintain it.

Here are a few tips we give our patients to care for their custom prosthetic:

  • Make sure you remove your device each night before bed and examine your limb for redness or irritation. If there is excessive discomfort, always return to your prosthetist for help.
  • Never sleep at night with the device on your limb. Your limb requires time to get air circulating around it and for it to be dry.  Wearing your limb 24 hours a day is not good for your skin.
  • Each day, clean your socket and prosthetic with mild soap and water to avoid bacteria and dirt buildup. Do not fully submerge your device in water unless it is waterproof. Doing so could cause water damage.
  • Only use your prosthetic device for the activities that it was designed to perform. Some devices aren’t designed to withstand high-impact activities or be submerged in water. For people who require a prosthetic design that allows them to participate in certain extracurricular activities, be sure to talk to your prosthetist about options that are available for sports or other physically strenuous activities.

HOPE KC is here to build the best custom prosthetic for you.

If you’re looking to get a custom prosthesis in Kansas City, Horizon Orthotic & Prosthetic Experience has six different locations in the Kansas City metro area and other Missouri cities to help you achieve your goals. Our customized prosthetic devices are made with the patient’s specific needs in mind.

We give our patients HOPE by providing them with the latest technology available in an effort to return them to the life they have longed for.

Contact us for more information on how to get a prosthesis in Kansas City.

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