Name of the Procedure:

Electronic elbow, microprocessor sequential control of elbow and terminal device (L7180)

• Common Names: Myoelectric arm, Bionic arm, Robotic elbow prosthesis
• Technical Term: Microprocessor-controlled prosthetic elbow

Summary

An electronic elbow prosthesis with a microprocessor control system helps individuals with arm amputations regain functional movement. It uses advanced technology to mimic the natural motion of the elbow and terminal device (hand or hook), allowing the user to perform various activities with greater ease and precision.

Purpose

This prosthesis is designed for individuals who have lost their elbow joint due to trauma, disease, or congenital conditions. The goals include improving the range of motion, enhancing daily activities, and increasing the overall quality of life by closely replicating natural arm movements.

Indications

• Traumatic or surgical amputation of the arm above the elbow.
• Congenital limb deficiency.
• Inability to perform daily activities with conventional prostheses.

Preparation

• Pre-procedure consultation to evaluate the patient’s specific needs.
• Measurement and fitting sessions to customize the prosthesis.
• Possible physical therapy sessions to enhance muscle strength and control.
• No special fasting or medication adjustments required for the fitting process.

Procedure Description

1. Initial Evaluation: Assess the patient's physical condition, residual limb, and specific requirements.
2. Fitting: Custom measurements are taken, and the prosthesis is tailored to fit the patient.
3. Calibration: The microprocessor is programmed for optimal control based on the patient’s muscle signals.
4. Training: The patient undergoes training sessions to learn how to control the prosthesis effectively.
5. Adjustment: Follow-up visits to fine-tune the device for maximum functionality.

Tools and Equipment:

• Microprocessor-powered elbow unit
• Electromyography electrodes (to detect muscle signals)
• Custom-fitted socket
• Terminal device options (e.g., hand or hook)

Duration

The initial fitting and adjustment phase can take several hours spread over multiple appointments. Subsequent training and fine-tuning sessions may continue for several weeks.

Setting

Primarily conducted in:

• Outpatient clinics specialized in prosthetics and orthotics
• Rehabilitation centers

Personnel

• Certified Prosthetist
• Physical Therapist
• Occasionally, Biomedical Engineer

Risks and Complications

• Minor skin irritation or pressure sores at the site of the prosthetic socket.
• Initial difficulty in operating the device, which generally improves with practice.
• Mechanical or software malfunctions requiring repairs or adjustments.
• Rarely, muscle fatigue or strain from operating the device.

Benefits

• Improved functional range of motion.
• Enhanced ability to perform daily tasks independently.
• Increased confidence and quality of life due to regained mobility. Benefits are often noticeable within weeks of successful adaptation and use.

Recovery

• Follow-up appointments for adjustments and troubleshooting.
• Consistent practice to ensure comfortable and efficient use.
• Physical therapy to strengthen muscles and improve control.
• Recovery time varies with individual adaptation, usually a few weeks to a few months.

Alternatives

• Conventional mechanical prostheses: Less complex, generally cheaper, but less functional.
• Body-powered prostheses: Uses cables and harness for movement, less intuitive.
• Cosmetic prostheses: Non-functional, primarily for aesthetic purposes. Pros and cons:
  • Conventional and body-powered prostheses are often more durable but less precise.
  • Cosmetic options offer better appearance but no functional movement.

Patient Experience

• Initial fitting may involve some discomfort as adjustments are made.
• Learning to control the prosthesis can be challenging but improves with practice.
• Ongoing support from healthcare professionals ensures comfort and efficiency.
• Pain management is usually minimal, primarily dealing with fitting-related issues.
• Most patients report high satisfaction once fully adapted and trained.