Abstract:
Management of high-level bilateral amputees poses a significant challenge for the
treating parties. Selection of the most appropriate prosthetic components and controls requires
knowledge of the many options available and the ability to predict which systems will most
benefit the user. Long-term follow-up of these individuals is rarely reported. Through
retrospective study it may be possible to identify attributes of prosthetic systems that have been
successful and incorporate those attributes in future systems. This paper outlines the prosthetic
management of an individual, KF, with traumatic bilateral shoulder disarticulation amputations
over a nineteen-year period.
In 1986, the Prosthetic/Orthotic Clinical Service Department of the Rehabilitation
Institute of Chicago (RIC) and the Rehabilitation Engineering Research Center (RERC) in
Prosthetics and Orthotics of Northwestern University began a collaboration to improve the
prosthetic fitting of persons with higher-level bilateral amputations. By the time of KF’s
admission to the RIC, a hybrid fitting concept had been developed using body-powered and
electric-powered components in a complementary manner to enhance the function of the total
prosthetic system [1,2]. Cable-actuated body-powered components were used on the dominant
side to take advantage of the physiological proprioceptive feedback intrinsic to cable control.
This prosthesis was used primarily for fine positioning and dexterous object handling and
manipulation. Electric-powered components were used on the non-dominant, or assistive, side to
provide higher gripping forces and greater lifting torque.
