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Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries
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Fergus Jepson @ MRF Childhood Amputee Day - Pushing the Boundaries

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Advancements in prosthetics

Advancements in prosthetics

Published in: Health & Medicine, Business
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  • 1. Dr Fergus Jepson MB ChB MRCSEd DORT FRCP Consultant in Amputee Rehabilitation Specialist Mobility Rehabilitation Centre Preston
  • 2. Introduction  Developments in prosthetics?  What can you expect from your centre?  Are children treated differently from adults?
  • 3. But before…  Let’s discuss how to classify different prosthetics
  • 4. Sockets and suspension  Interface between the body and prosthesis  Below knee amputation  Anatomical  Cuff  Supracondylar  Suction  Locking liner  Above knee  (TES) Belt  Suction  liner
  • 5. Socket – weight bearing  Below knee amputation  Patella Tendon Bearing  End bearing  Paratibials  Above knee amputation  Ischial tuberosity  Tuber bearing  Tuber containment  +/- end bearing  Bio-designs socket
  • 6. Knee units  Free or locked  Simplest is the SAKL – Semi Automatic Knee Lock  Locks straight automatically  Safest and most reliable  HOKL – Hand Operated Knee Lock  Ability of patient to choose when knee is locked  Option of safety in certain situations – weather etc  Free knee  Always free
  • 7. Knee components  Free knee continued  Unicentric  Polycentric  Micro-processor controlled  Pneumatic  Hydraulic  Power
  • 8. Ankle/foot  300+ prosthetic ankles on the market  Uniplanar  SACH foot  Multiflex  Adjustable heel  Energy return  carbon fibre foot spring  Blades  Hydraulic foot  Powered ankles  (few on the NHS)
  • 9. Accessory components  Shock absorbers  Rotation  Dynamic ankle  Beach activity limbs  Sports limbs
  • 10. Cosmesis  Standard definition  High definition
  • 11. Upper limb  Cosmetic  Standard definition  High definition  Functional  Mechanical  Body powered  Split hook  Mechanical hand  Myoelectric hand
  • 12. Weight category : 40+kg = adult
  • 13. Developments in Prosthetics  Microprocessor controlled knee joints  C-leg, Genium, Orion, Plie
  • 14. Developments in Prosthetics  Microprocessor controlled hands
  • 15. Developments in Prosthetics  Powered joints - Knees and ankles
  • 16. Areas of other development  Non – microprocessor controlled knees  Very Good Knee – fluidic controlled adaptive knee
  • 17. Areas of other development  Haudraulic ankle joint  Echelon foot first: now Echelon VT, Kinterra, Motion control
  • 18. Sports prosthesis  Running feet  Dedicated running limbs  Hybrid limbs
  • 19. Sports prosthesis  Swimming legs  Dedicated swimming legs  Dedicated feet for swimming  Other sports  Rock climbing  Ski feet
  • 20. What can you expect from your centre?  Each centre will have a limb prescription policy  Many centres will have dedicated paediatric limb prescription policies  Currently (and historically) each centre has a different arrangement with their Specialist commissioner (representing the PCTs for which they served)  Led to different management
  • 21. What’s coming…  Changes by the current government will mean  National commissioning  National tariff  National standards  Your choice to go to which ever centre you choose  But they should all be the same! As yet we do not know what that standard will be or how the tariff will be applied.
  • 22. Paediatric Limb prescription policy at the SMRC  2 activity limbs  Primary limb  For every day use  Secondary limb  Can be a replacement for everyday use or a dedicated sports limb e.g. running  Water activity limb  For showers, swimming, beach, pool  Others – exceptional circumstances  e.g. high definition limbs
  • 23. How does this differ from adult prescription policy?  Adult prescribing is very dependent on activity levels  We felt at the SMRC that children should have the right to run and engage in sports as much as they want to  There are no hybrid limbs for children until they can access adult limb sizes
  • 24. What is also important for multiple limb loss through meningitis?  Strong communication between  Special seating  Occupational therapy  Physiotherapy  Rehabilitation  Plastics / surgical specialities  Primary care
  • 25. Summary  Knowledge of what’s out there is very important  Discussing with your rehabilitation consultant and prosthetist how can your mobility be improved because prosthetics have improved  Trial children with adult components as soon as their shoe size and weight category allow
  • 26. The Sky is the limit! Thanks for listening Fergus.Jepson@lthtr.nhs.uk www.littlelegs.org.uk

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