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6a. Transradial Body-Powered Standards

Standards
1. Professionalism

NA

2. Universal precautions

NA

3. Bench test

Operation and setup of housing and cable

 Location of cuff straps on transradial prosthesis with flexible hinges

  • Standard: Should be located 2.5cm proximal to wrist (to allow maximum pronation/supination).

Control system efficiency >80%

F TD/Harness

 Control system efficiency (Efficiency = Force at TD/Force at harness)

  • Standard: At least 80% for single control harness
  • Standard: At least 50% for dual control harness

4. Socket Fit

First: CHECK Condition of residual limb!

ANATOMICAL LANDMARKS

TISSUE FIT

TRIMLINES AND ROM

 

Elbow flexion

 Elbow flexion/extension

  • Standard with flexible hinges: within 10` of active elbow ROM
  • Standard with rigid hinges: within 10` of active elbow ROM
  • Standard with self-suspension: ~105-110` elbow flexion

Elbow extension

Transverse rotation

Trimline location

 Self-suspension: encompass the epicondyles at the level of the P-M-L with enough of a brim to flare the soft tissue. Standard: 25mm proximal

STABILITY/LOAD TESTS

Elbow extension

Elbow flexion

Transverse rotation
  • Standard: minimal, if any, rotation of the socket with 3 lbs. force.

Axial Compression

Axial load <1” (2.5cm)
  • Standard: the prosthesis should not slip more than 1 inch and harness should not tear with 50lbs (or 1/3 body wt.) for axial load.

OVERALL SOCKET FIT

Distributed pressures

Socket comfort

Standards

5. Joint axis location

 

Joint Axis Location for Rigid Hinges for joint spacer installation

Standard:  Joint center located at axis of anatomical center

Standard: Distance from humeral cuff to olecranon is 25mm

6. Length of the prosthesis

Standard:  TD tip matches thumb tip of contralateral side

7. Alignment

 

8. Harness critique

 

Suspension:

 Don the prosthesis on the pt and check the harness fit

Standards:

  • The prosthesis suspends through the anterior suspensor.
  • Flexible hinges secured 2.5cm proximal to wrist and fall through elbow joint center through ROM. Adjust crosshanger as necessary.

Comfort (and cuff):

 Standards:

  • Harness should lay flat on the patient’s body, no edges cutting in
  • Inverted Y splits within 2.5cm proximal to the pectoralis tendon to 2.5cm distal to clavicle
  • Anterior suspensor is positioned in the delto-pectoral groove
  • Crosspoint is inferior to C-7 and 2.5cm (1”) toward the contralateral side
  • Cable should be either always on or always off the pts back

Operation:

9. Operation of the prosthesis

Elbow at 90 degrees

 Check that full opening and closing can be obtained in these positions.

Standards:

  • With elbow at 90 degrees = 90% opening

TD at waist
  • TD at waist = 70% opening

TD at mouth
  • TD at mouth = 70% opening

10. Technical quality

Plastic pulled with good suction, no defects in plastic, smooth and even edges/trimlines, rivets smooth with no sharp edges, straps, and materials clean, pads placed securely, harness clean and ends finished to avoid fraying.

11. Comprehension

12. Function 

 Standard: a patient is expected to be able to lift 20-30lbs using a transradial prosthesis, unless the residual limb is extremely short of sensitive

License

Upper Limb Prosthetics and Orthotics: Techniques Copyright © by Sue Spaulding. All Rights Reserved.

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