Prosthetics field advances, thanks to technology, options

2013-08-23T00:00:00Z Prosthetics field advances, thanks to technology, optionsBRIAN BETHEL Scripps Howard News Service Sioux City Journal
August 23, 2013 12:00 am  • 

ABILENE, Texas | Back when Aaron Jurkis started at Abilene Artificial Limb in 1995, he was sweeping the floors.

Today he is a certified prosthetist.

Jurkis said the options and technology available to patients are amazing compared to when he began his humble rise.

What hasn't changed, said both Jurkis and Scott Jameson, director orthotics and prosthetics at the West Texas Rehabilitation Center, is the satisfaction that comes in helping patients move in ways that may have seemed impossible after the loss of a limb.

Whether a patient's prosthetic is fairly basic or a wonder of science, when it comes to new patients, Jurkis said he always tells them that "90 percent of any prosthetic device is in your head and your heart."

"The other 10 percent is the stick I put underneath you," he said. "I tell everybody you can do everything you want to do with or on a prosthetic device, you may just have to find a little bit different way to do it."

Jameson said his is one of the only professions "in all of health care" that can see a patient come in riding a wheelchair in the morning, then come out pushing that same chair themselves.

"Being able to deliver that hope is more gratifying than anything," he said.

The socket, the part of the prosthesis that a patient's residual limb fits inside of, is fundamental to a patient's success, Jameson said.

The ideal goal is to "really try to make it feel like part of (the patient) as much as possible."

Every patient is a new challenge, Jurkis said, creating a sort of "puzzle-solving" aspect to the work.

There are a multitude of considerations, Jameson said, from patients' general physical condition and lifestyle to whether or not they often walk on uneven ground or smooth, flat floors.

In simpler times, making the socket involved a plaster mold, modified and shaped by hand, he said.

"Now we have a digital scanner," Jameson said. "We scan their limb. We come up with a computer model, and all the things that I used to do by hand with different tools, we can make all of those modifications with computer animated software."

Computer models can be sent to a "carver," which creates an exact mold of what was created on-screen, Jameson said.

From the initial computer scan, "diagnostic" sockets are created, he said.

"Once we feel like that socket is as perfect as we can be, we move to what we call a definitive socket," he said. "We put it in a material that's going to be as durable as possible and last a long time. Then we combine that with the (special-ordered) components we consider most appropriate for that patient. And then we do the fitting and delivery."

Gait training for legs is important to teach patients how to use and walk on their new limb. Physical therapy helps patients get stronger and increase their abilities, he said.

About 85 percent of amputations are due to diabetes, he said, meaning that such patients don't oftentimes heal as fast as they would like.

"We've got to get the limb where it's not longer swollen and in a stable state before we can start customizing a prosthesis to it, "he said. "You don't want it changing."

It takes about six to eight weeks, generally, from amputation to final product, he said.

Titanium and carbon fiber are still the most common materials seen in the prosthetics world, Jurkis said.

But these days, microprocessors in the knees, feet, arms and hands allow far better control and options for patients, he said.

"With the knees, there's much better stumble recovery," he said. When a user starts falling, such a knee can "kind of sense that, and then it locks up or freezes up just enough" to compensate.

Such devices also help patients go "step-over-step" when going down stairs.

The best artificial hands have independent fingers, instead of just working two or three, he said.

"And this doesn't sound like much to the layperson, but the (hand) has a wrist that naturally flexes, so when they put their hand down, the wrist will flex right away," he said. "That is a huge innovation in prosthetics."

War, unfortunately, is where a lot of innovations in prosthetics come from, Jurkis noted.

"Right now, they're working on the motors and pin systems for the joints in the fingers to make them more sturdy to pick up larger loads and things like that," he said.

Contact Brian Bethel of The Abilene Reporter-News in Texas at BethelB@reporternews.com. Distributed by Scripps Howard News Service, www.shns.com.

Copyright 2015 Sioux City Journal. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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