The document discusses advancements in upper extremity prosthetics, emphasizing custom design and fabrication techniques to improve comfort and functionality for amputees. Key innovations include myoelectric systems, which enhance control through muscle signals, and 3D printing technologies that streamline the fitting process. It also outlines the benefits and challenges of technologies such as osteo-integration and mind-controlled prostheses, highlighting a future where prosthetics can closely mimic natural limb performance.

1. Advancements in Upper Extremity
Prostheses
Rajnish Kumar Sharma
Assistant Professor(P&O)
Pandit Deendayal Upadhyaya National Institute for Persons with
Physical Disabilities,
Department of Empowerment of Persons with Disabilities,
Ministry of Social Justice & Empowerment,
Government of India

2. Disability is an opportunity for transcending the
ordinary for Empowerment
(Through Appropriate Prosthetic Intervention)
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3. Canyon
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4. Canyon
• A canyon is a deep, narrow valley with steep
sides. ... The movement of rivers, the
processes of weathering and erosion, and
tectonic activity create canyons.
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5. Canyoneering
• Canyoneering is the exploration of a canyon
from point A to point B using a range of
techniques that include hiking, scrambling,
sliding, stemming, chimneying and
rappelling. Imagine extreme hiking with a
harness, a helmet and appropriate rope
systems.
• Canyoneering is the intimate exploration of
forgotten Earth. It is poetry in movement.
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6. A R Rahman film composer, record
producer, singer and songwriter
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7. Aron Ralston
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8. Aron Lee Ralston
• An American outdoorsman, mechanical
engineer and motivational speaker known for
surviving a canyoneering accident by cutting
off part of his right arm.
• The incident is documented in Ralston's
autobiography Between a Rock and a Hard
Place and is the subject of the 2010 film 127
Hours where he is portrayed by James Franco.
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9. AR Vs AR
• American mountain climber Aron Ralston,
whose life is the subject of Danny Boyle's
movie '127 Hours', has complimented Indian
composer A.R. Rahman for his music in the
movie.
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10. AR Vs AR
• AR Rahman received a hand-written note
from Ralston, and he has posted a copy of the
note on his social networking accounts on
Facebook and Twitter.
• The note reads, "For A.R, Thank you for
bringing your amazing music to my story - if
only I had your soundtrack in the canyon, I
could've lasted another 127 hours. Best
Wishes, A.R. (Aron Ralston)."
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12. Prosthetics
• Prosthetics refers to the design, fabrication,
and fitting of custom-made artificial limbs or
other types of assistive devices for patients
who have lost limbs as a result of traumatic
injuries, vascular diseases, diabetes, cancer, or
congenital disorders.
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13. Prostheses
• Will restore – as completely as possible – the
function and appearance of a full or partial
missing limb.
• Because of vast differences in human anatomy,
the fabrication of prostheses is an intricate,
custom procedure that requires a high degree of
skill and sophisticated technology.
• The end goal, after all, is to develop a limb that
fits perfectly and gives the patient the utmost
level of comfort and convenience.
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14. UEP
• Developing a prosthetic device, such as an
upper extremity prosthesis, follows a careful
process from start to finish, all based on the
patient’s unique needs.
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15. UEP Processes
• After evaluating the patient, including detailed
measurements and fittings, the prosthesis is
designed.
• This design is determined by the patient’s
physical attributes, activity level, and
functional needs.
• Amputees generally require a new device
every few years for their lives.
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16. Advanced Upper Extremity Prostheses
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Significant Changes in Technology
• Prosthesis fingers have improved mechanics
and functionality and now have multiple
motors, better batteries, more intelligent
sensors, and more accurate grip strength
when handling something delicate.

17. Myoelectric / External Power
• A myoelectric upper extremity prosthetic device
is powered by a battery system and is controlled
by electromyography (EMG) signals generated
during muscle contractions received through
electrodes mounted in the socket.
• These signals are sent to a motor in the
prosthetic elbow and/or wrist. A myoelectric
elbow may then bend or straighten, a wrist can
flex, and a hand can open or close.
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18. Myoelectric / External Power
• It offers functional
cosmetic restoration;
• It can increase a
person’s grip force to
20-32 lbs;
• Harness system is
reduced or eliminated,
which offers comfort
and increased range of
motion.
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19. Partial Hand and Finger
• Finger and partial-hand amputees are among
the most common type of amputees.
• Recently a variety of options became available
for these prosthetic devices.
• Playing an important role for amputees, these
prostheses offer gripping options and counter-
support when grasping objects.
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20. Activity Specific Devices
• Designed to meet the
work or recreational
needs of the patient.
• These needs could
range from typing to
playing musical
instruments to playing
sports, and more.
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21. High Realism Silicone Prosthesis
• Designed to be unnoticeable by others.
• Each prosthesis is hand-crafted from high
definition silicone and hand-painted to match the
patient’s original skin tone and appearance.
• Most realistic, aesthetically pleasing, and
functional passive restoration
• Every detail is taken into account during the
painting of the prosthetic device, even accounting
for features such as freckles and hair.
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22. Morale Boost & Enhanced
Participation
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23. Hyper real
Some limbs even come with freckles and wrinkles if
you so choose
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24. Enhanced Independence through High
Tech Prosthesis
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25. Active ADL Performance
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26. This arm features a laser, magnifying
glass, cigarette lighter and other tools
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27. High fashion- to wear “going out” arm
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28. Upper Extremity Prosthesis for Sports
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29. Current Prosthetic Technological
Scenario
• Researchers at Berlin have developed an
artificial hand which uses smart wires that can
tense and flex as its muscles to perform
extremely precise movements.
• Engineers at Saarland University in Germany
enable development of flexible and lightweight
robot hands for industrial applications and novel
prosthetic devices.
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30. IMES
• Amputees can control their bionic prosthetic
limbs with their minds through tiny implanted
myoelectric sensors (IMES) developed by
Icelandic orthopedics company Ossur.
• Surgically implanted tiny sensors in a amputee's
residual muscle tissue.
• That trigger movement in the prosthesis via a
receiver.
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31. Osteo-integration
• Osteo-integration for limbs involves inserting
a metal rod into an arm bone.
• The bone then fuses with the rod in a manner
similar to fracture healing.
• The resulting implant offers numerous
benefits but also introduces some health
risks.
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32. Advantages of Osteo-integration
• increased comfort, especially with the elimination
of socket-related skin problems;
• it’s much easier to attach and detach a
prosthesis;
• greater strength/stability;
• more intuitive use of the prosthesis including a
broader range of motion;
• improved osteo-perception ;
• overall improved quality of life.
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33. Disadvantages of Osteo-integration
• it’s major surgery with a long recovery time;
• it involves significant costs;
• the implant presents a serious risk of deep
infection (up to 41 %);
• bone fractures occur in up to 9 % of the cases;
• implant parts break in up to 31 % of cases;
• the implants end up being removed in up to
roughly 20 % of the cases.
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34. Mind-controlled prosthesis
• In January 2013, Dr.
Rickard Brånemark led
the world’s first surgery
where neuromuscular
electrodes were
permanently implanted
in an amputee,
connecting prostheses
to the patient’s bone,
nerves, and muscles.
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35. The Next Generation Robotic Arm
• Conventional robotic prostheses available
today are attached with a socket and
controlled via electrodes placed on the skin.
• Robotic prostheses can be very advanced, but
such a control system makes them unreliable
and limits their functionality, and patients
commonly reject them as a result. By
connecting the prosthesis directly to bone,
nerves and muscles
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36. Integrum Robotic System
• The Integrum robotic system can provide a
significantly improved user experience.
• Unrestricted range of motion
• Precise and reliable prosthetic control
• Direct and intuitive neural sensory feedback
• Stable mechanical attachment
• Reduced phantom limb pain
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37. Mind-controlled prosthesis
• The artificial arm is
directly attached to the
skeleton, thus providing
mechanical stability. Then
the human’s biological
control system, that is
nerves and muscles, is
also interfaced via
neuromuscular electrodes
to the prosthesis via
Integrum’s advanced
control system.
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38. Mind-controlled prosthesis
• This creates an intimate union
between the body and the
prosthesis; between biology
and mechatronics.
• The stack connector interfaced
with a pin connector
extending from the central
sealing component, from
which leads extended
intramedullary and then
transcortically to a final
connector located in the soft
tissue. The leads from the
neuromuscular electrodes are
mated to connector.
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39. Mind-controlled prosthesis
• The prosthetic limb is
attached to the abutment,
which transfers the load to
the bone via the
osseointegrated fixture. The
abutment screw, which goes
through the abutment to
the fixture, is designed to
maintain the abutment in
place. A parallel connector
is embedded in the screw’s
distal end to electrically
interface the artificial limb.
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40. Mind-controlled prosthesis
• This connector is electrically
linked to a second feed
through connector embedded
in the screw’s proximal end.
• The stack connector interfaced
with a pin connector
extending from the central
sealing component, from
which leads extended
intramedullary and then
transcortically to a final
connector located in the soft
tissue. The leads from the
neuromuscular electrodes are
mated to connector.
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41. TMR
Targeted Muscle Re-innervation is the surgical
reassignment of nerves to alternative
muscles. It can prevent the formation of
neuromas, decrease phantom pain, and help
improve user control over myoelectric
devices.
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42. TMR
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43. 3D scanning and 3D printing
• Prosthetist utilizes 3D scanning and 3D
printing in the production of upper extremity
custom made prostheses.
• This technology enables to make the most
precise fitting prosthetic sockets.
• Scanners enhance experience as a patient
because it eliminate a lengthy casting
procedure of plaster or other wet, casting
products.
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44. 3D scanning and 3D printing
• Scanning procedure takes approximately 2-3
minutes and generates a 3 dimensional replica
of limb that is uploaded to software program
for computer-assisted modifications.
• 3D scanning also enables us to track any
changes occurring in limb and make changes
to system with more precision than other
companies that utilize casts and plaster molds.
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45. Advancements
• Incremental improvements in the flexibility,
cushioning, and rotational ability of modern
artificial limbs increase a prosthetic’s comfort
and functionality, allowing prosthetic wearers
to come closer to feeling like they are wearing
a natural limb. And as the quality
of prosthetics increases, prosthetic wearers
are more able to resume activities previously
made difficult by their lack of a natural limb.
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46. Prosthesis after tomorrow
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47. References
1. https://www.news18.com/news/india/aron-
ralston-praises-rahman-for-127-hours-music-
354222.html
2.https://www.biotechpossibilities.com/technol
ogy/prosthetics
3. https://en.wikipedia.org/wiki/Aron_Ralston
4.https://www.nationalgeographic.org/encyclop
edia/canyon/
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48. References
5. https://www.experiments-in
armwear.com/post/264903956/images-courtesy-
of-aron-ralston-copyright
6. https://www.inmotionprosthetics.com/blog
7. https://www.armdynamics.com/research-and-
technology/prosthetic-technology
8. https://www.researchgate.net/figure/A-
Prosthesis-control-can-be-achieved-through-
motor-commands-generated-through-
EEG_fig1_338317385
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49. Thank you