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15e. Shoulder Disarticulation Harness

The shoulder disarticulation prosthesis can be designed to provide substitutes for the lost functions of the hand, wrist, elbow and shoulder joint. The harness must be designed to:

  • capture suspension symmetrically across the right and left sides of the body, distribute the load and maintain prosthetic stability through various ROM
  • transmit excursion and force (inconspicuously) from the individuals body motion to the prosthesis.
    • * The suspension force vector needs to be different from the control/operation force vectors.
  • allow independent donning, doffing, and laundering
  • be comfortable and durable.

If the patient cannot successfully operate the prosthesis with the basic harness, three variations may be helpful:

  • Addition of an axilla loop
  • Addition of a shoulder sling with an axilla loop
  • Addition of an excursion amplifier
Basic Shoulder Harness with Axilla loop

  • Chest strap originates at anterior aspect of shoulder cap, runs across the chest, under the axilla, across the back, crosses over the ipsilateral shoulder and attaches at the anterior aspect of the shoulder cap (at the deltopectoral triangle).
  • A crossback strap extends from chest strap and attaches to the posterior aspect of socket at mid-scapular level.
  • The axilla loop is used to capture excursion (Figure 9 harness)
Basic Shoulder Harness with axilla loop and shoulder sling
Basic Shoulder Harness with two cables (unsure how they separate control between the two cables)
Basic Shoulder Harness with two cables
The waist band has a strap that is connected to the elbow lock control cable
For females

    • Avoid chest strap and use diaphragm strap either separated from or attached to a bra made of sturdy material
    • The same modifications can be made to this harness, eg – axilla loop.

 

Be creative!?!

 

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

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