Prosthesis cover

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Prosthesis cover

Post: # 39496Post admin
18 Feb 2019, 18:07

When Alina Miller underwent surgery for a transtibial amputation of her left leg in January 2016, she knew her life was going to change, but she was prepared.
The amputation surgery was her ninth operation. Miller broke both feet and her back when she jumped from her fourth-floor apartment's balcony after the building in Aurora, Colorado, was set on fire by an arsonist in August 2012. Her left foot never healed properly. It was a mass of scar tissue, her toes wouldn't bend, and she was in constant pain. "It was just easier to do the amputation than to have more surgery," says Miller, 28. "I woke up happy," Miller remembers about the surgery. "I was taking selfies with the nurses, and I told them I wanted a pink cast."

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Re: Prosthesis cover

Post: # 39497Post admin
18 Feb 2019, 18:08

Miller was in her first prosthesis with a basic carbon fiber socket by early March that year. Initially, she worried about matching it to her outfits, but those efforts faded quickly. "I realized that I was never going to be able to get them to match," she says.
Instead, she says, "I was going to build some excitement into my leg. It's not a death sentence because you have an amputation, and you certainly don't have to give up being fashionable."


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Re: Prosthesis cover

Post: # 39498Post admin
18 Feb 2019, 18:09

Patient Preference
While the older population tends to prefer natural skin tones for their prostheses, Hans Wulf Jr., CP, who has been with Infinite Technologies O&P, Fairfax, Virginia, since 2012, says, "Everyone likes different designs, whether it's to be artistic or just express themselves."
Julian Wells, CPO, FAAOP, clinical manager of Arm Dynamics' Kansas City, Kansas, location, agrees that natural skin tone covers are becoming less popular. It depends on the type of cover, the perspective of the wearer, and the environment where they intend to use the device, he says. "There's still a demand for skin tone or cosmetic covers," Wells says. "But each person is unique in what they consider an acceptable aesthetic for their prosthesis. In general, if the cover is designed to enhance the capability of the device by increasing the durability, protecting it from dirt, dust, or water, or allowing the patient to personalize their prosthesis in a unique way, the trend over the past ten years has been very positive."


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Re: Prosthesis cover

Post: # 39499Post admin
18 Feb 2019, 18:10

Within the last decade there has been a major shift in the perception, design, and message of prosthetic limbs, says Scott Summit, an industrial designer who cofounded Bespoke Innovations, San Francisco, in 2009 and sold it in 2012. "Aimee Mullens, Amy Purdy, and Chad Crittenden have shifted the focus from ‘dis-abled' to ‘super-abled', and transformed the idea of a prosthetic leg from the traditional, utilitarian device to something enabling and beautiful," he says.

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Re: Prosthesis cover

Post: # 39501Post admin
18 Feb 2019, 18:11

Blending Into the Crowd
Zach Harvey, CPO, Creative Technology Orthotic & Prosthetic Solutions, Denver, says prosthetic foam covers came into existence years ago with the advent of endoskeletal components. "Exoskeletal legs were the mainstream many years ago and the size and shape of the leg was important as well," he says. "Active amputees benefit from carbon fiber feet, the taller the better in terms of return on energy." However, many of these feet are hard to cover and resemble smaller versions of running feet, Harvey says. "The blades look cool and many people with little exposure to prosthetics think so too," he says. "They draw more attention, but it's generally positive attention."
When it comes to user preference the question is: Do they want a cover, or do they tend to shy away from them? There are those like Miller who embrace the uniqueness of their prostheses and select covers or finishes that display their creativity or individuality. Miller has a socket for almost every occasion, including dressing for a summer afternoon, an evening out, or going to the gym.
Some prosthesis users, however, don't want the attention having an amputation brings. They feel more comfortable blending into the crowd, according to Harvey and Wells. "They would rather the prosthesis look like a leg or an arm," Harvey says. "For some it might just be something to fill the pant leg out for dress slacks. For others, the need for detail with fingernails and toenails is important."


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Re: Prosthesis cover

Post: # 39502Post admin
18 Feb 2019, 18:12

Blending Into the Crowd
Zach Harvey, CPO, Creative Technology Orthotic & Prosthetic Solutions, Denver, says prosthetic foam covers came into existence years ago with the advent of endoskeletal components. "Exoskeletal legs were the mainstream many years ago and the size and shape of the leg was important as well," he says. "Active amputees benefit from carbon fiber feet, the taller the better in terms of return on energy." However, many of these feet are hard to cover and resemble smaller versions of running feet, Harvey says. "The blades look cool and many people with little exposure to prosthetics think so too," he says. "They draw more attention, but it's generally positive attention."
When it comes to user preference the question is: Do they want a cover, or do they tend to shy away from them? There are those like Miller who embrace the uniqueness of their prostheses and select covers or finishes that display their creativity or individuality. Miller has a socket for almost every occasion, including dressing for a summer afternoon, an evening out, or going to the gym.
Some prosthesis users, however, don't want the attention having an amputation brings. They feel more comfortable blending into the crowd, according to Harvey and Wells. "They would rather the prosthesis look like a leg or an arm," Harvey says. "For some it might just be something to fill the pant leg out for dress slacks. For others, the need for detail with fingernails and toenails is important."

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Re: Prosthesis cover

Post: # 39503Post admin
18 Feb 2019, 18:13

While some prosthesis users like the look of fairings, others look for durability or fashion, says Harvey, who has made countless covers. Some of those include fabricating a transtibial socket with a hollow exoskeletal shell that extended to the foot just to give the calf shape, using an embossing powder and a shiny fabric to make a leg that sparkles, fabricating a basic continuous cover that would not tear at the knee joint, and making a cover to fill out a thigh section for a client with a hip disarticulation who wanted to avoid tearing his pants.
An increasing number of people with amputations like the uncovered, high-tech look, says Wells. "We live in a time where words like robotic, bionic, and cyborg are part of our vocabulary, and some patients think it's interesting or fun to describe themselves using those terms." One of Wells' clients, Gerry Kinney, has bilateral transradial amputations and loves the bionic look. Kinney enjoys the attention from people asking about his prostheses.


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Re: Prosthesis cover

Post: # 39504Post admin
18 Feb 2019, 18:14

atour still has some of her early devices, which did include covers, she says. The inception of covers relates to the idea of cosmesis and blending in with society so not to appear different, she says. "Unfortunately, many of these covers were not lifelike and attracted more attention because the color did not match well," she says. "The advent of silicone and more sophisticated materials has helped to change things."
Prior to working in Colorado, Harvey worked at Walter Reed National Medical Center, Bethesda, Maryland, and found that most of the veterans he has worked with do not use prosthetic covers. "I believe this was part of the military's protocol [if they came through a military hospital], and the rapid changes in socket and components that we offered," says Harvey, although he once created a cover that contained a secret compartment to smuggle documents. "Covers were simply the last thing we had time to do," he says, but there were some veterans who were insistent on covers, whether those were traditional foam covers or 3D-printed fairings.


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Re: Prosthesis cover

Post: # 39505Post admin
18 Feb 2019, 18:15

For children, forget about foam covers, the experts say. "Children tear up foam covers in a matter of minutes," Harvey says. "Exoskeletal systems are still a viable option here." Harvey does a lot fabric-based designs for children as well as adults to make the prosthesis more personalized. "It's a matter of preference for the adult or the child whether they want the lamination to be skin-toned or have a fabric design."
While Wulf says his pediatric patients love showing off a new design, Wells says he has not experienced a trend with children or adults in either direction. "There are so many factors that involve the choice to cover or not cover the prosthesis," Wells says. "If a child is insecure with the appearance of their device, they may choose a skin tone cover in an effort to blend in and be less noticeable. Another child may prefer a cover or finish that's colorful and creates more of a ‘cool factor' in their mind and among their peer group."

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Re: Prosthesis cover

Post: # 39506Post admin
18 Feb 2019, 18:16

For the most part, Latour says her preference is no cover. "They have slowed down the function of both my body-powered and my externally powered devices," she says. "When I have had a cover, they often rip, look very shabby, and they soil easily. No one wants to be walking around with a dirty-appearing, torn up hand, especially if you're a therapist."
Though Latour's go-to prosthesis is a body-powered device, she recently received an i-limb quantum hand from Touch Bionics. "It does have a glove, which I am less than enthusiastic about, but I am looking forward to using this device," she says.


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