Prosthetics in North Carolina and in Vancouver, Canada

North Carolina

This is the first time I’ve seen any kind of hand prosthestic offering finger control. From a May 31, 2016 OrthoCarolina news release (received via email),

Two OrthoCarolina hand surgeons have successfully completed the first surgery to allow for a prosthetic hand with individual finger control on an amputee patient. Partnering with OrthoCarolina Research Institute (OCRI) in pursuit of medical breakthroughs through orthopedic research, Drs. Glenn Gaston and Bryan Loeffler conceptualized and performed the procedure involving transferring existing muscle from the fingers to the back of the hand and wrist without damaging the nerves and blood vessels to the muscles. The patient who underwent the test surgery is now able to control individual prosthetic fingers using the same muscles that controlled his fingers pre-amputation, making him the first person in the world to have individual digit control in a functioning myoelectric prosthesis.

“Patients who have sustained full or partial hand amputations obviously have significant morbidity and limited function, which is a challenge. Because of the limited number of muscles available after a hand amputation, prostheses have previously allowed only control of the thumb and fingers as a group and single finger control was never possible,” said Dr. Glenn Gaston.  “The severity of this patient’s injury was so great that replanting the lost fingers was not possible, so we collaborated on a new surgery that would allow him to have individual digital control.”

Hypothesizing that existing muscle in the back of human fingers could be transferred to the back of the hand and wrist without damaging the nerves and blood vessels to those muscles, Drs. Gaston and Loeffler first performed cadaveric testing to ensure feasibility. The goal of the initial project was for the small muscles that control individual fingers to regain control of prosthetic fingers by maintaining enough blood and nerve supply to allow the prosthetic limb to recognize individual digits.

With successful research completed, they collaborated with the Hanger Clinic to determine how much bone would be required to be removed from the hand, allowing the prosthetic componentry enough space to maintain a normal hand length.

The two surgeons jointly performed the surgery as a pilot case on a partial hand amputee, moving the muscles while still allowing the prosthesis to detect signals from the transferred muscles; a procedure never before reported in orthopedic literature.

“Imagine the limitations you would have if all of your fingers had to move as one unit, and then suddenly you were able to move individual fingers to perform specific actions,” said Dr. Bryan Loeffler. “This muscle transfer is a breakthrough that could impact how upper extremity amputees are managed and specific amputations are done in the future.”

Drs. Loeffler and Gaston have completed a cadaver model demonstrating the capability of the same type of surgery for a more proximal level total hand amputation. They presented their research at a podium presentation to the First International Symposium on Innovations in Amputation Surgery and Prosthetic Technologies (IASPT) May 12-13, 2016 in Chicago.

OrthoCarolina Research Institute is an independent non-profit committed to the advancement of orthopedic practice through clinical research. OCRI will continue to support this ground-breaking research and the manufacturing of this cutting edge prosthesis. “This is a tremendous example of the life-changing impact that orthopedic research plays in advancing patient outcomes,” said Christi Cadd, Executive Director of OCRI.

You can find out more about OrthoCarolina here.

Vancouver, Canada

While they celebrate exciting prosthetic news in North Carolina, those of us in Vancouver have been given the opportunity to view an unusual display of vintage artificial limbs (prosthetics) in an exhibition, All Together Now, featuring a number of rarely seen private collections including corsets, Chinese restaurant menus, and pinball machines. From a June 22, 2016 article by Janet Smith for the Georgia Straight, here’s more about the prosthetic collection,

For those unfamiliar, the lifelike artificial legs and arms that hang on the Museum of Vancouver’s wall might seem like medical oddities from a less advanced era.

But for collector David Moe, a certified prosthetist, they are integral, inspiring pieces for his career, his teaching, and his workspace.

“I love them all,” he says with enthusiasm, standing in the museum’s giant new exhibit All Together Now: Vancouver Collectors and Their World, in a corner of an expansive, cabinet-of-curiosities-styled room that houses everything from scores of local Chinese-restaurant menus to rows of 19th-century corsets and a glass case full of hundreds of action figures. “It’s very strange because they have been all around me for so long and they have sat in predominant spaces at work—they sit on the top of a shelf. So when I walk back in there right now there are these kinds of empty holes.

“But I’m happy to have them on display and to let people think about what they see and have the opportunity to have them think about prosthetics. Because nobody ever thinks about them until they need one.”

Moe began collecting almost from his start, at the age of 14, when he worked sweeping floors and pouring plaster at Northern Alberta Prosthetic & Orthotic Services, his family’s business in Edmonton. One of his first big finds was a leg that sits in the exhibit today—a meticulously carved wooden limb covered in smooth skin-tone leather, dating back to the 1930s. At the time, he recognized the craftsmanship and tucked it away where it wouldn’t disappear; today he still marvels at the anatomical design, with a hinged knee that bends with the use of straps.

“… . The math is the math. But we’ve moved so far. I really love where we’ve come from,” says Moe, gesturing to the vintage pieces he uses regularly to teach students at BCIT [British Columbia Institute of Technology]. He says he can appreciate the human touch and deep care that went into each one, then adds: “All of these were used by people, so the energy of these people is in these. I feel that responsibility of these people in here.”

To show how far his specialty has come, though, Moe has juxtaposed the historic limbs with modern-day advances—decorative limb coverings with fashionable latticework, or a kids’ shin piece that’s been emblazoned with a comic-book image of Superman. Now, instead of trying to just mimic natural limbs, some people are opting for statement pieces that actually draw attention to their prosthetic. “This empowers them in this powerless situation where someone has amputated your leg,” he notes.

As with other exhibits in All Together Now, there are audiovisuals that accompany his collection—in this case showing people using the advanced limbs of today, from a female triathlete carrying her baby to another client playing competitive volleyball.

“When someone does the Grouse Grind or, hell, just walks their child down the street, that’s when they come alive. We’re rebuilding lives, not pieces,” Moe says.

You can find out more about All Together Now here,

All Together Now: Vancouver Collectors and Their Worlds features 20 beautiful, rare, and unconventional collections, with something for everyone including corsets, prosthetics, pinball machines, taxidermy, toys, and much more. In this exhibition both collector and collected are objects of study, interaction, and delight.

The exhibition runs until January 8, 2017. The last Thursday of the month is by donation from 5 pm to 8 pm. More information about admission can be found here and you might also want to check out the exhibition’s Events page.

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