Upper Limb Pros

7/28/2019 Upper Limb Pros

1/48

Physical Rehabilitation Programme

trans-humeral Prosthesis

Manufacturing guidelines


2/48

International Committee of the Red Cross

19 Avenue de la Paix

1202 Geneva, Switzerland

T + 41 22 734 60 01 F + 41 22 733 20 57

E-mail: [email protected]

www.icrc.org

ICRC, September 2006

All photographs: ICRC/PRP


3/48

T of cott

Foreword 2

Introduction 41.Castingandrectication 5

2.Positioningothesocketcuportheelbowunit 6

3.Polypropylenedraping 7

4.Assembly 8

5.Makingthehookcableattachments 9

6.Polypropylenedrapingorcableattachment 11

7.Shapingthecableattachment 12

8.Fixationothehookcableattachments 13

9.Shoulderharness 14

10.Finishedtrans-humeralprosthesis 18

Listocomponents,CREquipmentsSA(CRE) 19

Listoothermanuacturingmaterials 20

Manuacturing Guid el ines Trans-Humeral P rosthesis


4/48 ICRC P hysical Rehab i l i tat ion P rog ramme

Foror

T ICRC poprop tcoo

Sinceitsinceptionin1979,theICRCsPhysicalRehabilitationProgrammehaspromotedtheuseotechnologythatisappropriatetothespeciccontextsinwhichtheorganizationoperates,i.e.,countriesaectedbywarandlow-incomeordevelopingcountries.

Tetechnologymustalsobetailoredtomeettheneedsothephysicallydisabledinthecountriesconcerned.

Tetechnologyadoptedmustthereorebe:

durable,comortable,easyorpatientstouseandmaintain; easyortechnicianstolearn,useandrepair; standardizedbutcompatiblewiththeclimateindierentregionsotheworld; low-costbutmodernandconsistentwithinternationallyacceptedstandards; easilyavailable.

Techoiceotechnologyisogreatimportanceorpromotingsustainablephysicalrehabilitationservices.

Forallthesereasons,theICRCpreerredtodevelopitsowntechniqueinsteadobuyingready-madeorthopaediccomponents,whicharegenerallytooexpensiveandunsuitedtothecontextsinwhichtheorganizationworks.TecostothematerialsusedinICRCprostheticandorthoticdevices

islowerthanthatothematerialsusedinappliancesassembledromcommercialready-madecomponents.

WhentheICRClauncheditsphysicalrehabilitationprogrammesbackin1979,locallyavailablematerialssuchaswood,leatherandmetalwereused,andorthopaediccomponentsweremanuacturedlocally.Intheearly1990stheICRCstartedtheprocessostandardizingthetechniquesusedinitsvariousprojectsaroundtheworld,orthesakeoharmonizationbetweentheprojects,butmoreimportantlytoimprovethequalityoservicestopatients.

Polypropylene(PP)wasintroducedintoICRCprojectsin1988orthemanuactureoprostheticsockets.Terstpolypropyleneknee-jointwasproducedinCambodiain1991;othercomponents

suchasvariousalignmentsystemswererstdevelopedinColombiaandgraduallyimproved.Inparallel,adurableoot,madeinitiallyopolypropyleneandEthylVinylAcetate(EVA),andnowopolypropyleneandpolyurethane,replacedthetraditionalwooden/rubberoot.

In1998,aercareulconsideration,itwasdecidedtoscaledownlocalcomponentproductioninordertoocusonpatientcareandtrainingopersonnelatcountrylevel.


5/48Manuacturing Guid el ines Trans-Humeral P rosthesis

Ojctiv of t

TeICRCsManuacturingGuidelinesaredesignedtoprovidetheinormationnecessaryorproductionohigh-qualityassistivedevices.

Temainaimsotheseinormativemanualsareasollows:

opromoteandenhancestandardizationoICRCpolypropylenetechnology; oprovidesupportortrainingintheuseothistechnology; opromotegoodpractice.

Tisisanothersteporwardintheeorttoensurethatpatientshaveaccesstohigh-qualityservices.

ICRCAssistanceDivision/HealthUnitPhysicalRehabilitationProgramme


6/48

Itroctio

Tisdocumentdescribesamethodorproductionotrans-humeral prostheses,workingwiththeICRCpolypropylenetechnologyandorthopaediccomponentsusedattheRegionalPhysical

RehabilitationCentreinBattambang,Cambodia.

Tecasting,recticationandalignmentmethodsusedcorrespondtointernationalprostheticandorthotic(P&O)standardsopracticeandarethereorenotdescribedintheseICRCmanuacturingguidelines.

ICRC P hysical Rehab i l i tat ion P rog ramme



CasTIng and ReCTIF ICaTIOn1

4Patientassessment,castingandrecticationopositivecastimpressionsareperormedinaccordancewithP&O

standards.

4Alignmentlinesantero-posteriorandmedio-lateral(A-P,M-L)aredrawnonthepositivemouldorproperpositioningotheelbowcup.Inmostcases,thiswillbealongthecentralaxisothetrans-humeralstump.

Drivenailsintothedistalendothecasttoensuregoodadherenceorthebuild-upotheplasterextension.



POsITIOnIng OF The sOCkeT CuP FOR The elbOw unIT2

4MakeaconicalextensiontubeusingEVA,plasticsheetingorsomeothersuitablematerialandpositionitaccordingtothe

alignmentlinesortheelbowcup.apetheconeinplaceandllitwithplasteruptothelevelotheproximalendotheelbowcup.

Formeasurementsseeollowingparagraph.

4Prolongtheproximalalignmentlinesalongtheplasterextensioninordertoacilitate

positioningotheelbowcup.

Temeasurementromtheacromiontothelateralepicondyleothesoundside,minusthedistanceromtheelbowaxistothedistalendotheelbowcup,willdeterminethelengthothetrans-humeralsocket.

Driveanailintothedistalpartothebuild-uptoensuregoodadherenceothecup,andxthecupinproperalignmentwithwet

plasterinaccordancewithP&Ostandards(useanalignmenttableiavailable).



POlyPROPylene d RaPIng3

4

Measurementsorpolypropylenesheet:

Cupcircumerence+2cm Acromioncircumerence+5cm Lengthoplastercast+15cm

Ticknessosheet:4mm

Heatthepolypropyleneinanovenorabout20minutesat

180C.

4Beoredrapingthepolypropylenesheet,pullastockingovertheplastermould.Cutitatthe

proximalpartotheelbowcupandxitwithcontactglue.Dustthestockingwithtalcumpowder.

4Drapethepolypropyleneovertheplastermodelandstickthesidestogetheralongthemedial

sideothesocket.ightenthepolypropylenearoundthesuctionconeortubeusingabicycleinnertube,ropeorstocking,thenopenthevacuumvalve.



assembly4

6Removetheplaster,shapethesockettrimlinesandgrindthemedialweldingseam.

Flattenthepolypropyleneonthedistalendotheelbowcup.

Assembletheelbowunitandcuttheorearmaccordingtothemeasurement.Telengthotheorearm,includingthehook,shouldbe1to2cmshorterthanthesoundside.Fixthewristunitwith4panheadPhillipsramingscrews(8x3mm).



4Forthehookcableattachments,duplicatetheoutsidedistalpartothetrans-humeralsocketandtheorearmwithplasterbandages.Fillthetwo

negativeswithplasterandsmooththem.

4Pullstockinetovertheplastermodels.

makIng The hOO k Cable aTTaChmenTs5



4Onthearmmould,placeabicyclebrakecablehousing7cmabovethedistalendotheelbowcupandcurvetheupperpartaccordingtothepositionotheharness.

Ontheorearm,placetheproximalcablehousingdummylaterally,3cmromtheelbowaxis,toallowullfexionotheorearm.Tedistalcablehousingisplacedontheanteriorpartotheorearm,atleast5cmromthewrist,toallowrotationothehook.

4Fixthecablehousingdummiestothestockinetwithcontactglue.

opreventthecablehousingsrombeingfattenedwhendrapingthepolypropylene,insertanelectricwireinthem.

Itispossibletomakeseveralhookcableattachments(e.g.leandright)onthesamemould.



POlyPROPylene dRaPIng FOR Cable aTTaChmenT6

4Drapea3mmpolypropylenesheetoverthearmusingthesamemeasurementsanddraping

techniquesasorthetrans-emoralsocket.

4Whenthepolypropylenehascooled,markthetrimlineso

thehookcableattachmentsandcutwithanoscillatingsaw.



shaPIng The Cable aTTaChmenT7

6Cutandshapethepolypropylenecablexationsandinsertthecablehousingintothechannels.

Drillholescorrespondingtothediameterothetubularrivetsorscrews(seenextparagraph).



FIxaTIOn OF The hOOk Cable aTTaChmenTs8

4Tenishedhookcableattachmentsareplacedinthesamepositionasontheplastermould.

Ontheorearmtheyarexedwithcountersunkheadsel-tappingscrews(d1=3mm,L=10mm).

4Onthetrans-humeralsocket,thehookcableattachmentisalsoplacedinthesamepositionasontheplastermould.

Fixtheattachmentwithtubularrivets(8x9mm).

Shouldthepositionotheattachmentshavetobechanged,warmthemwithaheatgunandmouldthemagainagainstthearmsocketororearm.



shOuldeR haRness9

6Insertthebicyclebrakecableintothehousing.Ontheproximalpart,xawebbinghangerwithascrewclamp.Onthedistalpart,makealoopwiththecableandsecureitwithasmallmetaltube(clampsleeve),whichisfattened(pressed)aroundthecable.

6Tesimplesttypeoharnessoroperatingthehookisthegureoeightsuspension.



4Foldthenylonbeltaroundtheoppositeshoulder.Teconnectionshouldbeadjustedinthemiddleotheback(spine).

4Stapleorclamptheharnesstogether.Whencuttingthebelt,leaveitalittlelongersothatitcanbereadjusted.

Checkwiththeamputeethatthecablecontrolsystemunctionsproperlyindierentarmpositions.

oopenthehook,thepatientmoveshisshoulderonthesoundside(oppositesideordoubleamputees)ortheprosthesisorward.

4

Oncetheharnesshasbeenadjustedsothattheamputeeeelscomortablewithit,sewthebeltconnectionandthexationontothewebbinghanger.



4opreventraying,meltthebresattheendothebeltwithaweldingiron.

4Teharnessisconnectedtothewebbinghangerontheposteriorside,whiletheotherendisxed

totheanteriorwallwithatubularrivet.

Teelasticstrapenablestheamputeetoopenandclosetheworkinghook.



6Otherharnessingsystems,suchasthoseproducedbytheOttoBockCompany,maybeused.



FInIshed TRans-humeRal PROsThesIs10

4Nexttothehookorworkingring,acosmetichandorothertoolrequiredbythepatientmaybeattached(screwedon).



ICRC Code DescriptionUnit ofmeasure

Quantity

OCPOELBOKIAOCPOELBOLIAOCPOELBOERA

*Elbow, adult*Elbow kits are available in three diferent colours. Choose ICRC code according to colour.**** Skin colour** Olive colour** Terra colour

One elbow kit comprises: Elbow unit Elbow cup with M6 T-nut Rubber joint, D70 x d6 x H3 mm PP wrist unit with M10 T-nut, dia. 45 mm Pan head Phillips raming screws 8 x 3 mm or wrist unit

Kit

EachEachEachEachEach

1

11114

OCPOHOOKAL

OCPOHOOKAR

KORTHOOKSP

*Hook, adult, let, stainless steel, M10 threadAccording to side o amputation

*Hook, adult, right, stainless steel, M10 thread*According to side o amputation

Spare parts or hook:Rubber washer, D30x d10x H6 mmStainless steel spring

Each

Each

EachEach

1

1

1010

OCPOHOOKKRT *Working round ring tool, stainless steel with rubber washer*On request by amputee

Each 1

OCPOHANDERMLOCPOHANDERMR

OCPOHANDERWLOCPOHANDERWR

Terra colour:Hand, man, let, terra colourHand, man, right, terra colour

Hand, woman/child, let, terra colourHand woman/child, right, terra colour

EachEach

EachEach

11

11

OCPOHANDKIMLOCPOHANDKIMROCPOHANDKIWLOCPOHANDKIWR

Beige colour:Hand, man, let, beige colourHand, man, right, beige colourHand, woman/child, let, beige colourHand, woman/child, right, beige colour

EachEachEachEach

1111

OCPOHANDLIMLOCPOHANDLIMROCPOHANDLIWLOCPOHANDLIWR

Olive colour:Hand, man, let, olive colourHand, man, right, olive colourHand, woman/child, let, olive colourHand, woman/child, right, olive colour

EachEachEachEach

1111

lit of copot, CR eqipt sa (CRe)



ICRC Code DescriptionUnit ofmeasure

Quantity

MDREBANDP10

MDREBANDP12

Plaster bandages 10 cmorPlaster bandages 12 cm

According to stump dimension

OMIS Plaster o Paris According to cast dimension

OMIS Nails Each 4

OPLAEVAFERA03OPLAEVAFKIN03OPLAEVAFLIV03

EVA 3 mm, plastic sheet or other or extension tube Each 1, dimension according to TH socketextension length

OMIS Tubular nylon stocking, 60 or 80 mm or PP draping Each 1, length according to TH socket

OMIS Bicycle brake housing dummies with electric cable Each Length described in book cableattachments

OPLAPOLYCHOC04OPLAPOLYCHOC05

OPLAPOLYSKIN04OPLAPOLYSKIN05

OPLAPOLYLIV04OPLAPOLYLIV05

Polypropylene 4 or 5 mm according to patient size:Polypropylene 4 mm, terra brownPolypropylene 5 mm, terra brown

Polypropylene 4 mm, beigePolypropylene 5 mm, beige

Polypropylene 4 mm, olivePolypropylene 5 mm, olive

Each Dimension explained in PP drapingtechnique

OPLAPOLYCHOC03OPLAPOLYSKIN03OPLAPOLYLIV03

Polypropylene 3 mm or cable attachment dummies:Polypropylene 3 mm, terra brownPolypropylene 3 mm, beigePolypropylene 3 mm, olive

Each

OMIS Defnitive bicycle brake cable with housing Each 1, cut according to patient sizeOMIS Fixation or cable attachment on orearm:Countersunk head sel-tapping screws d1 = 3 mm,L = 10 mm

Each 4

OHDWRIVET081

Fixation or PP cable attachment on trans-emoral socketand harness:Tubular rivets 8 x 9 mm

Each 5

OMIS PP webbing hanger or other fxation method Each 1

OMIS

OCPOELBOHAR

Harness nylon (or other) belt (width 25 mm) with elasticstrap (width 25 mm)orHarness or upper limb prostheses

Each 1, length according to patient size

lit of otr fctri tri


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MISSION

The International Committee of the Red Cross (ICRC) is an impartial, neutral andindependent organization whose exclusively humanitarian mission is to protect thelives and dignity of victims of war and internal violence and to provide them withassistance. It directs and coordinates the international relief activities conductedby the Movement in situations of conict. It also endeavours to prevent suffering

by promoting and strengthening humanitarian law and universal humanitarianprinciples. Established in 1863, the ICRC is at the origin of the International RedCross and Red Crescent Movement.

Acknowledgements:

Jean Franois GallayLeo GasserPierre GauthierFrank JoumierJacques LepetitBernard Matagne

Joel NiningerGuy NuryPeter PoetsmaHmayak Tarakhchyan

and all prosthetists-orthotists who have worked in ICRC-assisted physical rehabilitation centres.


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0868/002

09/200

6

200


25/48

Physical Rehabilitation Programme

trans-radial Prosthesis

Manufacturing guidelines


26/48

International Committee of the Red Cross

19 Avenue de la Paix

1202 Geneva, Switzerland

T + 41 22 734 60 01 F + 41 22 733 20 57

E-mail: [email protected]

www.icrc.org

ICRC, September 2006

All photographs: ICRC/PRP


27/48Manuacturing Guid el ines Trans-Rad ial P rosthesis

T of cott

Foreword 2

Introduction 41.Castingandrectication 4

2.Positioningthewrist 5

3.Polypropylenedrapingorstsocket 7

4.Productionosecondsocket 9

5.Positioningocablehousing 9

6.Polypropylenedrapingosecondsocket 10

7.Fixationocablehousing 12

8.Cablecontrolsystem(harness) 14

9.Fitting 17

Listocomponents,CREquipmentsSA(CRE) 19

Listoothermanuacturingmaterials 20

Manuacturing Guid el ines Trans-Rad ial P rosthesis



Foror

T ICRC poprop tcoo

Sinceitsinceptionin1979,theICRCsPhysicalRehabilitationProgrammehaspromotedtheuseotechnologythatisappropriatetothespeciccontextsinwhichtheorganizationoperates,i.e.,countriesaectedbywarandlow-incomeordevelopingcountries.

Tetechnologymustalsobetailoredtomeettheneedsothephysicallydisabledinthecountriesconcerned.

Tetechnologyadoptedmustthereorebe:

durable,comortable,easyorpatientstouseandmaintain; easyortechnicianstolearn,useandrepair; standardizedbutcompatiblewiththeclimateindierentregionsotheworld; low-costbutmodernandconsistentwithinternationallyacceptedstandards; easilyavailable.

Techoiceotechnologyisogreatimportanceorpromotingsustainablephysicalrehabilitationservices.

Forallthesereasons,theICRCpreerredtodevelopitsowntechniqueinsteadobuyingready-madeorthopaediccomponents,whicharegenerallytooexpensiveandunsuitedtothecontextsinwhichtheorganizationworks.TecostothematerialsusedinICRCprostheticandorthoticdevices

islowerthanthatothematerialsusedinappliancesassembledromcommercialready-madecomponents.

WhentheICRClauncheditsphysicalrehabilitationprogrammesbackin1979,locallyavailablematerialssuchaswood,leatherandmetalwereused,andorthopaediccomponentsweremanuacturedlocally.Intheearly1990stheICRCstartedtheprocessostandardizingthetechniquesusedinitsvariousprojectsaroundtheworld,orthesakeoharmonizationbetweentheprojects,butmoreimportantlytoimprovethequalityoservicestopatients.

Polypropylene(PP)wasintroducedintoICRCprojectsin1988orthemanuactureoprostheticsockets.Terstpolypropyleneknee-jointwasproducedinCambodiain1991;othercomponents

suchasvariousalignmentsystemswererstdevelopedinColombiaandgraduallyimproved.Inparallel,adurableoot,madeinitiallyopolypropyleneandEthylVinylAcetate(EVA),andnowopolypropyleneandpolyurethane,replacedthetraditionalwooden/rubberoot.

In1998,aercareulconsideration,itwasdecidedtoscaledownlocalcomponentproductioninordertoocusonpatientcareandtrainingopersonnelatcountrylevel.



Ojctiv of t

TeICRCsManuacturingGuidelinesaredesignedtoprovidetheinormationnecessaryorproductionohigh-qualityassistivedevices.

Temainaimsotheseinormativemanualsareasollows:

opromoteandenhancestandardizationoICRCpolypropylenetechnology; oprovidesupportortrainingintheuseothistechnology; opromotegoodpractice.

Tisisanothersteporwardintheeorttoensurethatpatientshaveaccesstohigh-qualityservices.

ICRCAssistanceDivision/HealthUnitPhysicalRehabilitationProgramme



Itroctio

Teaimothisdocumentistodescribeamethodorproducingtrans-radial prostheses withinterchangeable sockets,workingwiththeICRCpolypropylenetechnologyandorthopaedic

componentsusedattheRegionalPhysicalRehabilitationCentreinBattambang,Cambodia.

Tecasting,recticationandalignmentmethodsusedcorrespondtointernationalprostheticandorthotic(P&O)standardsopracticeandarethereorenotdescribedintheseICRCmanuacturingguidelines.

CasTIng and ReCTIF ICaTIOn1

4Patientassessment,castingandrecticationopositivecastimpressionsareperormedinaccordancewithP&Ostandards.

4Alignmentlinesantero-posteriorandmedio-lateral(A-P,M-L)aredrawnonthepositivemouldorproperpositioningothewrist.Inmostcasesthiswillbealongthecentralaxisothetrans-radialstump.

Drivenailsintothedistalendothecasttoensuregoodadherenceorthebuild-upotheplasterextension.



POsITIOnIng The wRIsT2

4MakeaconicalextensiontubeusingEVA,plasticsheetingorsomeothersuitablematerial

andplaceitaccordingtothealignmentlinesorwristpositioning.apetheconeinplace.

Filltheextensionconewithplasterupto5mmhigherthanthelevelothewrist,soastoleaveroomorshapingthecorrectanglesothewrist.

4Prolongtheproximalalignmentlinesalongtheplasterextensioninordertoacilitatepositioningothepolypropylenewrist.



4Smoothandshapethebuild-upsothatitisperectlyconical,otherwiseitwillbedicultto

exchangethesocketsinthistechnique.

4Temeasurementromtheolecranontotheradialstyloidprocessothesoundsidewilldeterminethelengthotheprosthesistothedistalendothewristunit.

Telengthotheprosthesismaybe1to2cmshorterthanthesoundside,butneverlonger.


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2

1

3

Manuacturing Guid el ines Trans-Rad ial P rosthesis

POlyPROPylene dRaPIng OF FIRsT sO CkeT3

4

Measurementopolypropylenesheet:

Wristcircumerence+2cm Epicondylecircumerence+4cm Lengthoplastercast+15cm

Tickness3or4mm,dependingonpatient.

4Beoredrapingthepolypropylenesheet,pullastockingovertheplastermould.Cutitatthe

proximalpartothewristandxitwithcontactglue.Dustthestockingwithtalcumpowder.

4Heatthepolypropyleneinan

ovenorabout20minutesat180C.

Drapethepolypropyleneovertheplastermodelandstickthesidestogetheralongtheposteriorside.ightenthepolypropylenearoundthesuctionconeortubeusingabicycleinnertube,ropeorstocking,thenopenthe

vacuumvalve.



4Usingscissorsoraknie,cutotheleoverpolypropyleneotheweldingseamwhileitisstillhot.

Keepthevacuumonuntiltheplastichascooleddown.

4Removetheplaster,shapethesockettrimlinesandgrindtheposteriorweldingseam.

Drillahole(dia.20mm)onthemedial/distalsideorpullingthestumpsocket.

Flattenthepolypropyleneonthedistalendothewrist.

Checkthesocketontheamputee

orcomort,suspensionandlength.



POsITIOnIng OF Cable hOusIng5

4Drawalineromtheproximaltothedistalpartonthemid-anteriorothesocket.Te line must stop at least5 cm from the wrist.Tisindicatesthepositionorthecablehousingdummy.

4akeabicyclebrakecablewithhousing,cutitinaccordancewiththelengthothelineandxitonthestockingwithcontactglue.

PROduCTIOn OF seCOnd sOCkeT4

6Aerthersttting,llthesocketwithplasteragainandprepareitordrapingthesecondsocket.Pull4cottonstockinettubesand1nylonstocking(toobtainasmoothsurace)overtherstsocket.



POlyPROPylene dRaPIng OF seCOnd sOCkeT6

4Heatastripopolypropyleneandshapeittothesocket,1cmabovetheplannedtrim

linesothe2ndsockettoavoidfaringatthetrimmededgesothissocket.Tiswillalsoprotectthe1stsocketwhenthesecondoneisbeingcut.

4Drapea3mmpolypropylenesheetoverthesocket,usingthesamemeasurementsanddrapingtechniqueasorthe1stsocket.

Whenthepolypropyleneiscool,cutitonthestripwithanoscillatingsaworhacksaw.

4Removethe2ndpolypropylenesocketandtheplasterinsidethe1stsocket.



6Tetrimlinesothe2ndsocketshouldbeapproximately3cmdistaltothetrimlinesotheanteriorsideothe1stsocket,andshoulddip6cmintheposteriortocreateears/wingsonthemedialandlateralsides.

Tiswillpreservesomefexibilityorthe1stsocketandpreventrotationothe2ndsocket.

rimothedistalendbythewrist,leavingitfushwiththelengthothe1stsocket.



FIxaTIOn OF Cable hOusIng7

4Removethecablehousingdummywithlongfatnosepliersoranawl.

4Cutanddrillopeningsintheendsothechannelcreatedbythecablehousing.



4Insertthedenitivecablehousingandpushitinsidethechannelwitharivetingbar.

4Tecablehousingshouldextendatleast2cmoutsidethedistalchannelopeningtoprotectthecablewirerombendingandbreaking,andtoallowenoughroomorthecabletoopenthehookully.



4Temostsimpletypeoharnessoroperatingthehookisthegureoeightsuspension.

Stapleorclampanylonbelt(30mmwide)onthewebbinghanger.

Cable COnTROl sysTem (haRness)8

4Insertthebicyclebrakecableintothehousing.Ontheproximalpart,xapolypropylenewebbinghangerwitha

screwclamp.Onthedistalpart,makealoopwiththecableandsecureitwithasmallmetaltube(clampsleeve),whichisfattened(pressed)aroundthecable.



4Foldthenylonbeltaroundtheoppositeshoulder.

Teconnectionshouldbeadjustedinthemiddleotheback(spine).

4Stapleorclamptheharnesstogether.Whencuttingthebelt,leaveitalittlelongersothatitcanbereadjusted.

Checkwiththeamputeethatthecablecontrolsystemunctionsproperlyindierentarmpositions.

oopenthehook,thepatientmoveshisshoulderonthesoundside(oppositesideordoubleamputees)ortheprosthesisorward.

6Oncetheharnesshasbeenadjustedsothatamputeeeelscomortablewithit,sewthebeltconnectionandthexationontothewebbinghanger.



4opreventraying,meltthebresattheendothebeltwithaweldingiron.

4Finishedprosthesiswithinterchangeablesocket.



FITTIng9

4Terstsocketcanbeusedwithacosmetichand,aworkingringorothertoolsnotrequiringthecable

controlsystem.

4Checkwiththeamputeethatthesecondsocketslideseasilyovertherst.



4eachthepatienthowtousetheinterchangeabletrans-radialsocketsandhowtoconnectandusetheharnessandthecable-operatedhook.



ICRC Code DescriptionUnit omeasure

Quantity

OCPOWRISKIAOCPOWRISLIAOCPOWRISERA

PP wrist unit, adult, with M10 T-nut (dia. 45 mm) and 4 pan head Phillips ramingscrews, 8 x 3 mm* Wrist units are available in 3 diferent colours. Choose ICRC code according to colour **** Beige colour** Olive colour** Terra colour

Each 1

OCPOHOOKAL

OCPOHOOKAR

KORTHOOKSP

Hook, adult, let, stainless steel, M10 threadAccording to side o amputation

Hook, adult, right, stainless steel, M10 threadAccording to side o amputation

Spare parts or hook:

Rubber washer, D30x d10x H6 mmStainless steel spring

Each

Each

EachEach

1

1

1010

OCPOHOOKKRT * Working round ring tool, stainless steel with rubber washer* On request by amputee

Each 1

OCPOHANDERMLOCPOHANDERMROCPOHANDERWLOCPOHANDERWR

Terra colour:Hand, man, let, terra colourHand, man, right, terra colourHand, woman/child, let, terra colourHand woman/child, right, terra colour

EachEachEachEach

1111

OCPOHANDKIMLOCPOHANDKIMR

OCPOHANDKIWLOCPOHANDKIWR

Beige colour:Hand, man, let, beige colourHand, man, right, beige colour

Hand, woman/child, let, beige colourHand, woman/child, right, beige colour

EachEach

EachEach

11

11

OCPOHANDLIMLOCPOHANDLIMROCPOHANDLIWLOCPOHANDLIWR

Olive colour:Hand, man, let, olive colourHand, man, right, olive colourHand, woman/child, let, olive colourHand, woman/child, right, olive colour

EachEachEachEach

1111

lit of copot, CR eqipt sa CRe


46/480 ICRC P hysical Rehab i l i tat ion P rog rammeICRC P hysical Rehab i l i tat ion P rog ramme

ICRC Code DescriptionUnit omeasure

Quantity

For frst TR socket:

MDREBANDP10

MDREBANDP12

Plaster bandages 10 cmorPlaster bandages 12 cm

Each According to stump dimension

OMIS Plaster o Paris According to cast dimension

OMIS Nails Each 2

OPLAEVAFERA03OPLAEVAFKIN03OPLAEVAFLIV03

EVA 3 mm, plastic sheet or other or extension tube Each 1, dimensions according to extensionlength

OMIS Tubular nylon stocking, 60 or 80 mm or PP draping Each 1, length according to prosthesis

OPLAPOLYCHOC03OPLAPOLYCHOC04

OPLAPOLYSKIN03OPLAPOLYSKIN04

OPLAPOLYLIV03OPLAPOLYLIV04

Polypropylene 3 mm or 4 mm according to patient size:Polypropylene 3 mm, terra brownPolypropylene 4 mm, terra brown

Polypropylene 3 mm, beigePolypropylene 4 mm, beige

Polypropylene 3 mm, olivePolypropylene 4 mm, olive

Each Dimension explained in PP draping

For second TR socket:

MDREBANDP10 Plaster bandage 10 cm Each According to frst socket size

OMIS Plaster o Paris According to frst socket size

ODROSTOCOT60 Cotton stockinet 60 mm or PP draping Each 4 , length according to prosthesis

OMIS Nylon stocking or PP draping Each 1, length according to prosthesis

OMIS Bicycle brake cable housing dummy Each 1, cut according to socket length


Polypropylene 3 mm or trim line strip:Polypropylene 3 mm, terra brownPolypropylene 3 mm, beigePolypropylene 3 mm, olive

Each 1, width: 20 mm, according tocircumerence


Polypropylene 3 mm or 2nd socketPolypropylene 3 mm, terra brownPolypropylene 3 mm, beigePolypropylene 3 mm, olive

Each Dimensions explained in PP drapingo 2nd socket

OMIS Defnitive bicycle brake cable housing Each 1, cut according to socket length

OMIS Bicycle brake cable Each 1, length according to patient size

OMIS PP webbing hanger or other fxation method Each 1

OSBOVSB24 Nylon (or Perlon) belt or harness, width 25 mm Each 1, length according to patient size

lit of otr fctri tri


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MISSION

The International Committee of the Red Cross (ICRC) is an impartial, neutral andindependent organization whose exclusively humanitarian mission is to protect thelives and dignity of victims of war and internal violence and to provide them withassistance. It directs and coordinates the international relief activities conductedby the Movement in situations of conict. It also endeavours to prevent suffering

by promoting and strengthening humanitarian law and universal humanitarianprinciples. Established in 1863, the ICRC is at the origin of the International RedCross and Red Crescent Movement.

Acknowledgements:

Jean Franois GallayLeo GasserPierre GauthierFrank JoumierJacques LepetitBernard Matagne

Joel NiningerGuy NuryPeter PoetsmaHmayak Tarakhchyan

and all prosthetists-orthotists who have worked in ICRC-assisted physical rehabilitation centres.


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Upper Limb Pros

Documents

Transcript of Upper Limb Pros