Prosthetics

Prosthetics - a system of medical, technical and organizational measures, aimed at restoration of the lost forms or functions of separate organs or bodies themselves. Conventionally, there are prosthetics anatomical, functional and therapeutic.
Under anatomical prosthetics understand restore mainly the form of lost body and partially functions (without other energy sources), such as prosthetic arms and legs, eyes (see artificial Eyes), teeth (see dentures), ears and nose, breast and other
Functional prosthesis involves the use of external sources
energy to maintain the functions of a limb or organ, such as prosthetic hands with bioelectric management, hearing AIDS (see) and others;
active prostheses, movements are produced, the remaining parts of the extremities, shoulder or pelvic girdle, movements of the torso.
Medical prosthesis directed usually on a time limit functions of bodies such as the use of corsets in scoliosis, orthopedic devices (see), orthopedic footwear (see) and other
There are prostheses of lower and upper extremities. For lower-limb prostheses are prosthetic feet, legs, hips and wilasinee thigh (without feet). The foot prosthesis made after removing part of the foot or after her amputation according to Pirogov; they sufficiently replace the missing part of the leg. On shank stump produce prostheses with conventional and floating movable sleeve (Fig. 1). In hip prostheses are artificial ankle and knee joints, significantly reducing podkopayevoy (instability) of the prosthesis. Close by the castle in the knee joint considerably complicates the gait, makes it cosmeticos.
After velomania hips made prosthesis with polyuretan (Fig. 2, 1 and 2), the hip joint and lock in the knee joint.prosthesis

Fig. 1. Prosthesis foot after the amputation, according to Pirogov (left) and Shin prostheses floating selection sleeve (right). Fig. 2. Dentures: 1 - thigh to ankle and knee joints; 2 - with polyuretan, hip joint and lock knee pain after hip disarticulation. Fig. 3. The prosthetic hand: 1 - cosmetic hands; 2 - active after the amputation shoulder.
prosthesis shoulder
Fig. 4. The layout of the prosthesis shoulder with bioelectric control (mechanical part): 1 - brush with the electric drive; 2 - sleeve forearm; 3 - motor mechanism cubits; 4 - reducer; 5 - slip clutch; 6 - worm gear; 7 - gear clutch; 8 - sleeve and shoulder; 9 - mechanism passive arm rotation.

Fig. 5. Work prosthesis after amputation of the forearm (left) and a set of working tools (on the right).


The upper-limb prostheses, depending on the destination are divided into beauty, reproducing the external form of the hands (Fig. 3, 1), active, reproducing some of motion and function Tong (Fig. 3, 2), workers. In addition, the prostheses are distinguished by segment limbs: brushes, forearms, shoulder and vilamendhoo shoulder. Active prostheses give the opportunity to serve themselves, to write. To work apply working prostheses with a sleeve with a nozzle, which are inserted working adaptations (Fig. 5). To actuate prostheses used electric energy and the energy of compressed gas. There are bioelectric prostheses (Fig. 4); the methods of assignment of bioelectric signals from the muscles of the hand using overhead electrodes and strengthen them in electronic semiconductor amplifier. The amplified signal controls the operation of the electric motor of a direct current. All these devices are in the prosthesis.
For implants in the medical Department of orthopedic enterprises withdraw the measure doctor and techniques.
Training in the use of prostheses produced in the medical Department or hospital complex prosthetics with prosthetic enterprise. Prosthetic enterprise are used almost in every region, the province and the Autonomous Republic and subordinated to the organs of social security.
Principles of prosthesis are free and available to supply all those who need prostheses, AIDS, corsets, except orthopaedic footwear, which is issued free of charge to the disabled of the 1st group, and others for a fee. On average 2 year replacement of old prostheses new, also free. Dental patients are sent medical institutions of the place of residence.
Contraindications to the prosthesis are not enough decorated swollen stump after the amputation, the presence on the cult unhealed wounds, acute inflammatory processes (phlegmon, furuncles), abrasions, non-healing fistula, osteomyelitis, etc. When prosthetics medical indications and contraindications are set only by the doctor of the medical Department of prosthetic enterprise.
When properly prosthetics restores the ability to work in cases of amputation hip - up to 90%, and amputation of the upper limb - up to 40%.


Prosthetics (Franz. prothese, from the Greek. prosthesis - attachment, Appendix) - system of measures on compensation of lost or functionally defective parts of the body and organs with the help of mechanical devices - dentures. Conventionally, there are prosthetics anatomical, functional and therapeutic. To anatomical prosthetics include the use of artificial limbs, eyes, dentures (see) and other Functional prosthesis helps in varying degrees, to restore lost function (see Hearing AIDS). Many anatomical prostheses are both functional, while others have only cosmetic. Medical prosthesis aims to promote healing; it means serve orthoses (see), orthopaedic footwear and other
One of the main tasks of prosthetics - to fill the form and function of the missing limb. As a result of amputation, velomania or congenital underdevelopment remains segment or part of the segment limb - stump (see). To replace a missing limb is made prosthesis, strengthened on the cult using a special sleeve. The better sleeve fitted to the cult, it will be more convenient use of the prosthesis. Modern prostheses made from wood, metal (light alloys and plastics. Semi-finished products for manufacturing of metal dentures produce of the plant. Semashko in Moscow, wooden - in Chernikovka and Shaksha (about Ufa) and hence send prosthetic and Assembly enterprises. In each such enterprise has a medical Department, where doctors and technicians take orders for prostheses and devices. All prosthetic-orthopedic products (except orthopaedic footwear) are issued to the needy free of charge.
There are a prosthetic devices of upper and lower extremities. For lower-limb prostheses are prosthetic feet, legs, hips and prosthesis with polyuretan after hip disarticulation.
Prosthetic feet produce after the amputation of feet in the joints of Lafrance, Sapara or after the amputation, according to Pirogov (Fig. 1); prostheses sufficiently replace the missing part of the limb as in the anatomical and functional relationship. On shank stump produce prostheses with the sleeves is common, floating (mobile) (Fig. 2) and become automatically self-centering plastic. Difficult prosthetics at the stumps of lower leg shorter than 7 cm, as you have manufacturing overhead covers, multi hinges.
Significantly complicated and strenuous walking in hip prostheses (Fig. 3). The presence of two hinges - ankle and knee - significantly reduces podkopayevoy prosthesis. As a result, some disabled persons, particularly older people, go with a closed lock in the knee joint, which significantly complicates the gait and makes it not cosmetic. To increase podkopayevoy in hip prostheses do drivelines, complicate mount thigh with the help of a belt or bandage is applied vacuum attachment.
After hip disarticulation used denture polyuretan (Fig. 4), the hip joint and lock in the knee joint. The lower limb prostheses are made on special individual scheme. To ensure the sustainability of these prosthetic knee joint refer back towards the hip and ankle 15 mm, the length of the prosthesis make shorter healthy feet on 1,5-2 cm for free rackets prosthesis with step.
The upper-limb prostheses is divided into beauty, reproducing only
a hand shape (Fig. 5), active, reproducing some of motion and function setting (Fig. 6), and workers (Fig. 7). These dentures differentiate and segment limbs: brushes, forearms, shoulder and after a distillation of his shoulder. Active prostheses allow us to serve themselves, to write. Working prostheses have the usual case with an attachment, you can insert it working adaptations (Fig. 8).
Active prostheses are driven by the movement of the remaining parts of the extremities, shoulder or pelvic girdle, the movement of the body. Recently began to use electric energy and the energy of compressed gas. Central Institute of prosthetics designed prosthesis with bioelectric control (Fig. 9). Bioelectric signals are removed from the muscles stump using overhead electrodes and amplified in electronic semiconductor two-channel amplifier. The amplified signal controls the operation of the electric motor of a direct current. The energy of compressed gas (usually CO2) is used in air prostheses Leningrad Institute of prosthetics. Energy source are compressed under high pressure gas. Managing such a prosthesis is made using the distributive valves, driven by muscular effort.
For implants in the medical Department of orthopedic enterprises withdraw the measure doctor and techniques. Usually measured not anatomical length of the extremities, and functional. On lower limb length hip measured from the crotch to the cracks of the knee, Shin - from the cracks of the knee to the floor, feet - from the middle of the back of a contour heel to the end of the second finger. Upper limb is measured from the edge of the humeral head to external condyle (shoulder length), from external condyle up to the head of the radial bone (the length of the forearm) and from the head of the radial bone up to the end of the middle finger (the length of the brush). The circumference is measured on three levels each segment limbs in the proximal, average and distal third. If necessary, make a mold, especially with short stump. Dentures are made and issued under the control of doctors and technicians.
On orthopedic enterprises are hospitals that are trained to use the prostheses. Periodically preventive inspections of persons enjoying the prosthetic and orthopedic products.