Prosthesis with electric elbow and hand for a three-year-old multiply handicapped child

The usefulness of wisely prescribed powered components in the rehabilitation of upper extremity amputees has long been recognized (Schmidl, 1973). Their value is especially evident in the prosthetic rehabilitation of high level adult and child amputees (Heger et al, 1985). In recent years, manufacturers of prosthetic hardware have provided practitioners with a wide selection of either myo-electrically or switch controlled electromechanical components and systems. As a rule, however, most commercially available components are designed to serve the adult amputee and do not lend themselves for use in the prosthetic rehabilitation of children. One current exception is the availability of child-size electric hands. The availability of the world's first child-size electric hand in 1970 at the Ontario Crippled Children's Centre later known as the Variety Village 105 hand, gave tremendous impetus to the fitting of younger children with externally powered components and myoelectric control systems. However, this trend served to benefit the young below-elbow patient only (Sorbye et al, 1972). The successful fitting of higher amputation levels in this age group stopped at the elbow level. Existing artificial elbows such as the Variety Village and Hosmer elbow with their necessary powerpacks are simply too bulky and too heavy for pre-school age children. The need for a lightweight compact electric elbow, suitable for 3-8 year old children, still has not been addressed. This single case report illustrates an innovative and successful conversion of a 6-3/4 Otto Bock hand into a small electric elbow. The idea was first proposed by Schmidl (1973).