A spotlight on the customisation and fitting of legs

Oliver KennettInterview, Leg News, Tanzania, Teaching

There are many stages in getting an African amputee walking again, not least of which is making sure that the equipment we provide is appropriate for the task. Through the highly skilled Prosthetists at our partner hospitals and clinics in Africa, the recycled prosthetic limb that we send out can be assessed, restored and, finally, customised for its intended recipient.

[Here we have a description from one Adam McMurray who spent his summer in the orthopedic workshop at Muhimbili National hospital in Tanzania. His interest in sport and engineering has culminated in an interest in prosthetic devices and forms a large part of his final year studies for his Bachelor of Mechanical Engineering degree which he is reading at Dublin institute of technology

Adam has a specific interest  in transfemoral prosthetic design for developing countries and realised that the best way to learn was with some hands on experience. “Going to Tanzania was very informative for me to do first person/ primary research into how prosthetics worked, how they were made, how they were fitted and any problems that the amputees experienced with them.”

Adam recognises that, as with many things, reading books is no substitute for rolling up ones sleeves and getting involved. His experience in the prosthetics and orthopaedic workshop of Muhimbili hospital gave him a practical insight into the customisation and fitting of prosthetic limbs.

“The prostheses they fitted ranged between upper and lower limb prostheses but mainly dealing with lower limb. I learnt how to measure a patients remaining limb (stump), to make a plaster cast and plaster mould of the patients stump. This plaster mould was used to design the socket for the patient.”

He discovered that they used two materials for the stump sockets, plastic, which required a vacuum sealing process to set, and a carbon fibre resin which requires more time but produces a harder waring socket. The socket would then be attached to the actual prosthetic limb, usually with an epoxy resin, which would set before trying it for a fit on the patient.

Once the best fit has been found for the socket, it must then be correctly attached to the permanent part of the prosthetic . This can take several more attempts before the correct alignment is made and the prosthetic leg is finally ready to be used. The patient can receive up to eight hours of training with their new prosthetic leg where they learn exercise to increase strength where muscle has most likely atrophied, but also good hygiene and care for both their stump and prosthetic leg to avoid, at least discomfort at worst infection.

Adam’s experience shows that the work of Legs4Africa, collecting and shipping recycled prosthetic limbs to Africa, is just the tip of the iceberg. It takes time and dedication of volunteers, professionals and, not least, the patient’s themselves to make this work.

“This has been an exciting and extremely useful experience. After college I want to continue working in the field of Biomedical Engineering, with a focus on working with all types of prosthetics.”

Legs4Africa is fortunate to have a growing network of hospitals and clinics in sub-Saharan Africa with highly skilled individuals who can effectively employ these salvaged materials. Through the ongoing work of such people, along with the support of our donors of funding, equipment and time, Legs4Africa is continuing to get more people walking again and to help restore lives adversely affected by limb loss.