The Prosthesis Process
The process that leads to getting a prosthesis is a long, tough road that has many hurdles and obstacles. It involves multiple test fittings, countless revisions, and no shortage of adaption to life with one less part of you.
The first step of the process, obviously, is the removal of the limb. There are several reasons for an amputation to occur, the most common being catastrophic injury (i.e. broken limb with no chance of repair), and illness (i.e. osteomyelitis, a bone infection, osteosarcoma, cancer of the bone and diabetes). 82% of all amputations in the United States are caused by vascular disease, and nearly 70% of all amputations involve the upper extremities (arms, hands, fingers). Roughly 2 million people have had an amputated limb in the US, and 185,000 amputations occur per year. (A video on the actual surgery is linked in the Videos page.)
The next step of the process is rehabilitation following an amputation. Rehabilitation includes treatments to improve overall wound and stump care, activities to restore movement and the ability to do normal activities, exercises to promote muscle strength, endurance and control, pain management for postoperative pain and "phantom" pain (pain caused by the feeling of the limb still being "attached".), emotional care to help with the grieving period and readjustment to the patient's body image, the use of assistive devices (outside of a prosthesis), adapting the patient's home for functionality, safety and accessibility, and education for both the patient and their family.
The third step following recovery is being fitted for a prosthesis. This usually happens 4-6 weeks post-operatively once the incision has healed, and swelling has gone down. This part of the process starts with a prosthetist examining the remaining parts of your limb and helping the patient decide what aspects of their prosthetic work best for them (i.e. will they be more or less active then they were before their limb was amputated? Do they plan on returning to work? Will they be participating in sports?) and from there, the prosthetist will then cast the socket, the part of the prosthesis that connects directly to the remaining portion of the patient's limb. Casting is done one of two ways; either with plaster dipped bandages that conform directly to the shape and contour of the patient's remaining limb, or it can be done with laser scanning in some cases. Laser scanning may be more accurate as it captures which areas are more sensitive. From there, the patient is fitted with a test socket to examine how their remaining limb conforms to the socket. Then, components that make up the whole prosthesis are added gradually to see how well the patient can use the limb. In some cases, this prosthesis may be worn for a longer time (usually only in the case of new amputees) to give the wearer time to adapt to wearing a prosthesis and gradually conform to the prosthesis better. Patients also may undergo occupational therapy in this time to ease into wearing/using a prosthesis. (A video going into better detail on how a prosthesis is created is linked in the Videos page.)
The final step in the process is receiving the "final" version of your prosthesis. This usually occurs several months after the amputation procedure. This involves adapting the first test socket into a custom socket, and then all of the components will be attached. From there, a cosmetic covering can be added if the patient so chooses. This prosthesis may take several visits to the prosthetist to create and perfect it's fit. However, even though this is called the "final" prosthesis, it will only last 2-5 years depending on the patient's activity level, and it will last significantly less in children due to their variable growth. It's also important to remember that the prosthesis will need regular maintenance and repair when parts break in order to keep it functional for it's entire projected lifespan.