Prostheses – Upper Limb

The type of prosthesis that is given to a child depends on many factors that will be assessed by the Clinic Team (usually, a Doctor, Prosthetist and an Occupational Therapist) at your local Limb Centre. Broadly speaking there are two main types of prosthesis that may be considered for prescription: cosmetic prostheses and functional prostheses.

As the name implies, a cosmetic prosthesis designed to look as natural as possible. It will be as lightweight as possible and will not usually contain any moving parts. Despite the lack of a moving hand, a cosmetic prosthesis can be extremely useful, as the child can support objects with his or her prosthetic hand.

A functional prosthesis contains a moving hand or hook which may be opened by the child through the use of a simple harness, or by the use of electricity. The functional prosthesis is heavier than a cosmetic prosthesis and will need more maintenance, but with suitable training will allow a greater degree of personal independence.

Training in the use of artificial arms is carried out by specialist occupational therapists who work
closely with the prosthetists.

Prostheses are constructed from a combination of custom-made and commercially available components. The most important part is the socket which transmits the various forces to the deficient arm and often prevents the prosthesis from falling off. If the socket is not comfortable, then even the most sophisticated prosthesis in the world will be unusable.

The socket is made from a plaster of Paris bandage cast of your child’s deficient arm together with various measures. The position that it is cast in is crucial to the success of the prosthesis. The prosthetist then fills the female cast with plaster, strips off the bandages and is then left with a model of the deficient arm. This model is rectified (adjusted) in order to help with force transmission, comfort and suspension. Once the prosthetist is happy with the plaster cast, he or she passes it on to the prosthetic technician who then builds the prosthesis to the prosthetist’s instructions.

From A Guide to Artificial Arms by Mark Broomfield The National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, reproduced here with permission from REACH