An Immediate Fit, Adjustable, Modular Prosthetic System for Addressing World-Wide Limb Loss Disability

Abstract

Prosthetic services and resources globally are insufficient to meet the needs of individuals with lower limb loss worldwide, particularly in low resource countries. The lack of trained prosthetists, high cost, and inaccessibility of prosthetic services leave many patients in these countries without a prosthesis. To address this problem, an immediate fit, adjustable, modular, prosthetic system was developed. Six individuals in Jamaica with transtibial lower limb loss who were in need of a prosthesis visited a local therapy clinic. They were fit with the prosthetic system by a physical therapist certified and trained in the proper fitting of these devices. All patients were fit on the first visit and walked out with a comfortable prosthesis after some rehabilitation gait training. Five of the patients returned for follow-up and reported that they continued to use these devices for daily wear. No adverse events or socket component failures were reported despite rigorous daily use in a rugged environment. This new prosthetic care delivery model-a modular system distributed to patient locations and fit by trained allied rehabilitation professionals-holds potential for meeting the large demand for lower limb prosthetics in developing countries.

Keywords: Amputation; Case report; Rehabilitation.

Fig 1

Components of the immediate fit prosthesis. (A) Lateral view of prosthesis displaying locking buckle system; (B) medial view of prosthesis displaying hooks used to make fine adjustments to the socket's circumference; and (C) the “prosthesis in a box” kit including a socket, neoprene liner, padding kit, spacers, adhesive, pylon, tube clamp, pins, and various sized cables. All that is needed in addition to the kit is a sleeve with pin attachment (pins are included) for suspension and a prosthetic foot. (D) A 5-mm perforated neoprene liner shown with additional pads (arrow) that stick to the liner with velcro and can be placed to relieve socket pressure and reduce discomfort. These pads allow for a customized socket fit.

Fig 2

The prosthetic foot (left) showing breakdown of the outer cover after 6 months of use. The iFIT socket (right) remained in working order over 7 months after being used extensively while performing this individual's occupation (agricultural work).

Fig 3

The iFIT prosthesis was successfully fit on a 12-year-old boy. It accommodated his growth.