[Prostheses for armless children and young people--experiences and conclusions (author's transl)]

Despite the many--often allegedly sensational--advances in the field of arm prosthetics, we continue to be far removed from satisfactory solutions especially where the needs of armless and bilaterally phocomelic children and young people are concerned. Continuing intensive research and development are needed but will never be able to render superfluous the compensatory potentialities of the feet in substituting hand function. Work to date in development and testing of technical aids for disabled children, which has been grant-aided generously over the past by the Federal Ministry of Youth, Health, and Family, as well as the Federal Ministry of Labour and Social Order, have enabled us here in our Heidelberg clinic to elaborate the catalogue of indications and contraindications described for the prosthetic management of armless or phocomelic children and young people; to develop child- and age-adapted programmes for the training of compensatory functions; technical aids for coping with the activities of daily living, and to achieve the described further developments in the field of prosthetics. These novel types of prostheses have meanwhile been used successfully for patients with accident-related armlessness. These experiences are of use not only to the field of prosthetic management but beyond that to the entire rehabilitation programming for armless persons, on the medical side of which highest priority is given to the training of inherent compensatory functions (hand function substituted for by the feet in the case of normal hip and knee joints, otherwise by the mouth), aimed at achieving maximum independence in daily living activities and as a preparation for best-possible integration in the educational, vocational, and social fields.