A firefighter with burn injuries demonstrated fitting challenges regarding comfort
and suspension of a functional upper limb prosthesis. This case study introduces a
transhumeral-transfemoral patient who was injured during a volunteer firefighting
incident. The patient sustained several injuries which resulted in amputation of the
right leg just proximal to the knee and a transhumeral amputation of the left upper
limb. The patient has full range of motion in both shoulders and elbows, yet the strength
and dexterity of his right hand has been compromised.
This individual sustained burns to 60% of his body, including the skin on his left
transhumeral residual limb. Due to the delicate nature of his skin, a suction socket
was contraindicated. Over the next four years, different types of custom and non-custom
locking and cushion liners were utilized for patient comfort and suspension of both
a myoelectric and a conventional (body-powered) prosthesis. The integration of electrodes
for dual site myoelectric inputs offered additional challenges that compromised the
suspension provided by silicone suction. Shuttle locks, lanyards, and proximal locking
mechanisms were used, and the advantages and disadvantages of each system will be
This case study will follow the progression of suspension techniques, interface designs,
and other clinical challenges faced by the patient and the clinicians involved with
the fitting. As the patient progresses toward his imminent evaluation for Targeted
Muscle Reinnervation surgery, his existing design must be modified to allow additional
EMG sites. The challenges of this firefighter’s progressive fitting and treatment
will be detailed in the discussion.
Proceedings of the MEC'11 conference, UNB; 2011.
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