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Experience has shown that people with upper limb differences have better rehabilitation outcomes when the prosthetic fitting process is completed in a short span of time. Our expedited fitting process gives focused, personalized attention to each patient over a period of one to five days. During this time, an upper limb prosthetist and occupational therapist work together to develop a rehabilitation plan, cast and fit an initial prosthesis, and guide the patient in how to use it for daily tasks. This interactive process allows our clinical team to tailor the prosthesis in real time, giving patients confidence and maximizing their rehabilitation. Expedited fitting occurs in three phases:
The prosthetic interface or socket is custom made to fit the precise contours of the patient’s residual limb. Starting with a plaster cast of the residual limb, a mold can be made for creating the socket. For the initial test socket, clear plastic is heated, stretched over the plaster mold and carefully pressed into each contour. The patient tries on the socket and the prosthetist begins to identify pressure points or other concerns. The comfort of the socket is essential since it connects the prosthesis to the patient’s body; therefore, multiple test sockets may be made to perfect the fit and suspension.
For a myoelectric prosthesis, the controls phase is identifying electrode sites on the patient's residual limb and transferring them to the test interface/socket. Electrodes are mounted inside the test socket to receive the patient's muscle signals, which are called “EMG” signals. For body-powered prostheses, the harness, cable and housing that control the prothesis are attached to the socket and adjusted. The controls phase is completed when optimal control and comfort have been achieved.
A rigid frame is fabricated for the socket and all prosthetic components are attached. Alignment focuses on the orientation of the patient’s shoulder, elbow, hand and wrist to maximize function and cosmetic restoration.