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Transradial Body-Powered Standards

Standards
1. 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
2. Professionalism

NA

3. Universal precautions

NA

4. 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

5. 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

6. 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

7. Length of the prosthesis

Standard:  TD tip matches thumb tip of contralateral side

8. Alignment

 9. 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:

10. Technical Operation of TD

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

11. 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.

12. Comprehension

License

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

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