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Physical Rehabilitation Programme
trans-humeral Prosthesis
Manufacturing guidelines
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International Committee of the Red Cross
19 Avenue de la Paix
1202 Geneva, Switzerland
T + 41 22 734 60 01 F + 41 22 733 20 57
E-mail: [email protected]
www.icrc.org
ICRC, September 2006
All photographs: ICRC/PRP
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T of cott
Foreword 2
Introduction 41.Castingandrectication 5
2.Positioningothesocketcuportheelbowunit 6
3.Polypropylenedraping 7
4.Assembly 8
5.Makingthehookcableattachments 9
6.Polypropylenedrapingorcableattachment 11
7.Shapingthecableattachment 12
8.Fixationothehookcableattachments 13
9.Shoulderharness 14
10.Finishedtrans-humeralprosthesis 18
Listocomponents,CREquipmentsSA(CRE) 19
Listoothermanuacturingmaterials 20
Manuacturing Guid el ines Trans-Humeral P rosthesis
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4/48 ICRC P hysical Rehab i l i tat ion P rog ramme
Foror
T ICRC poprop tcoo
Sinceitsinceptionin1979,theICRCsPhysicalRehabilitationProgrammehaspromotedtheuseotechnologythatisappropriatetothespeciccontextsinwhichtheorganizationoperates,i.e.,countriesaectedbywarandlow-incomeordevelopingcountries.
Tetechnologymustalsobetailoredtomeettheneedsothephysicallydisabledinthecountriesconcerned.
Tetechnologyadoptedmustthereorebe:
durable,comortable,easyorpatientstouseandmaintain; easyortechnicianstolearn,useandrepair; standardizedbutcompatiblewiththeclimateindierentregionsotheworld; low-costbutmodernandconsistentwithinternationallyacceptedstandards; easilyavailable.
Techoiceotechnologyisogreatimportanceorpromotingsustainablephysicalrehabilitationservices.
Forallthesereasons,theICRCpreerredtodevelopitsowntechniqueinsteadobuyingready-madeorthopaediccomponents,whicharegenerallytooexpensiveandunsuitedtothecontextsinwhichtheorganizationworks.TecostothematerialsusedinICRCprostheticandorthoticdevices
islowerthanthatothematerialsusedinappliancesassembledromcommercialready-madecomponents.
WhentheICRClauncheditsphysicalrehabilitationprogrammesbackin1979,locallyavailablematerialssuchaswood,leatherandmetalwereused,andorthopaediccomponentsweremanuacturedlocally.Intheearly1990stheICRCstartedtheprocessostandardizingthetechniquesusedinitsvariousprojectsaroundtheworld,orthesakeoharmonizationbetweentheprojects,butmoreimportantlytoimprovethequalityoservicestopatients.
Polypropylene(PP)wasintroducedintoICRCprojectsin1988orthemanuactureoprostheticsockets.Terstpolypropyleneknee-jointwasproducedinCambodiain1991;othercomponents
suchasvariousalignmentsystemswererstdevelopedinColombiaandgraduallyimproved.Inparallel,adurableoot,madeinitiallyopolypropyleneandEthylVinylAcetate(EVA),andnowopolypropyleneandpolyurethane,replacedthetraditionalwooden/rubberoot.
In1998,aercareulconsideration,itwasdecidedtoscaledownlocalcomponentproductioninordertoocusonpatientcareandtrainingopersonnelatcountrylevel.
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Ojctiv of t
TeICRCsManuacturingGuidelinesaredesignedtoprovidetheinormationnecessaryorproductionohigh-qualityassistivedevices.
Temainaimsotheseinormativemanualsareasollows:
opromoteandenhancestandardizationoICRCpolypropylenetechnology; oprovidesupportortrainingintheuseothistechnology; opromotegoodpractice.
Tisisanothersteporwardintheeorttoensurethatpatientshaveaccesstohigh-qualityservices.
ICRCAssistanceDivision/HealthUnitPhysicalRehabilitationProgramme
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Itroctio
Tisdocumentdescribesamethodorproductionotrans-humeral prostheses,workingwiththeICRCpolypropylenetechnologyandorthopaediccomponentsusedattheRegionalPhysical
RehabilitationCentreinBattambang,Cambodia.
Tecasting,recticationandalignmentmethodsusedcorrespondtointernationalprostheticandorthotic(P&O)standardsopracticeandarethereorenotdescribedintheseICRCmanuacturingguidelines.
ICRC P hysical Rehab i l i tat ion P rog ramme
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CasTIng and ReCTIF ICaTIOn1
4Patientassessment,castingandrecticationopositivecastimpressionsareperormedinaccordancewithP&O
standards.
4Alignmentlinesantero-posteriorandmedio-lateral(A-P,M-L)aredrawnonthepositivemouldorproperpositioningotheelbowcup.Inmostcases,thiswillbealongthecentralaxisothetrans-humeralstump.
Drivenailsintothedistalendothecasttoensuregoodadherenceorthebuild-upotheplasterextension.
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POsITIOnIng OF The sOCkeT CuP FOR The elbOw unIT2
4MakeaconicalextensiontubeusingEVA,plasticsheetingorsomeothersuitablematerialandpositionitaccordingtothe
alignmentlinesortheelbowcup.apetheconeinplaceandllitwithplasteruptothelevelotheproximalendotheelbowcup.
Formeasurementsseeollowingparagraph.
4Prolongtheproximalalignmentlinesalongtheplasterextensioninordertoacilitate
positioningotheelbowcup.
Temeasurementromtheacromiontothelateralepicondyleothesoundside,minusthedistanceromtheelbowaxistothedistalendotheelbowcup,willdeterminethelengthothetrans-humeralsocket.
Driveanailintothedistalpartothebuild-uptoensuregoodadherenceothecup,andxthecupinproperalignmentwithwet
plasterinaccordancewithP&Ostandards(useanalignmenttableiavailable).
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POlyPROPylene d RaPIng3
4
Measurementsorpolypropylenesheet:
Cupcircumerence+2cm Acromioncircumerence+5cm Lengthoplastercast+15cm
Ticknessosheet:4mm
Heatthepolypropyleneinanovenorabout20minutesat
180C.
4Beoredrapingthepolypropylenesheet,pullastockingovertheplastermould.Cutitatthe
proximalpartotheelbowcupandxitwithcontactglue.Dustthestockingwithtalcumpowder.
4Drapethepolypropyleneovertheplastermodelandstickthesidestogetheralongthemedial
sideothesocket.ightenthepolypropylenearoundthesuctionconeortubeusingabicycleinnertube,ropeorstocking,thenopenthevacuumvalve.
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assembly4
6Removetheplaster,shapethesockettrimlinesandgrindthemedialweldingseam.
Flattenthepolypropyleneonthedistalendotheelbowcup.
Assembletheelbowunitandcuttheorearmaccordingtothemeasurement.Telengthotheorearm,includingthehook,shouldbe1to2cmshorterthanthesoundside.Fixthewristunitwith4panheadPhillipsramingscrews(8x3mm).
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4Forthehookcableattachments,duplicatetheoutsidedistalpartothetrans-humeralsocketandtheorearmwithplasterbandages.Fillthetwo
negativeswithplasterandsmooththem.
4Pullstockinetovertheplastermodels.
makIng The hOO k Cable aTTaChmenTs5
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4Onthearmmould,placeabicyclebrakecablehousing7cmabovethedistalendotheelbowcupandcurvetheupperpartaccordingtothepositionotheharness.
Ontheorearm,placetheproximalcablehousingdummylaterally,3cmromtheelbowaxis,toallowullfexionotheorearm.Tedistalcablehousingisplacedontheanteriorpartotheorearm,atleast5cmromthewrist,toallowrotationothehook.
4Fixthecablehousingdummiestothestockinetwithcontactglue.
opreventthecablehousingsrombeingfattenedwhendrapingthepolypropylene,insertanelectricwireinthem.
Itispossibletomakeseveralhookcableattachments(e.g.leandright)onthesamemould.
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POlyPROPylene dRaPIng FOR Cable aTTaChmenT6
4Drapea3mmpolypropylenesheetoverthearmusingthesamemeasurementsanddraping
techniquesasorthetrans-emoralsocket.
4Whenthepolypropylenehascooled,markthetrimlineso
thehookcableattachmentsandcutwithanoscillatingsaw.
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shaPIng The Cable aTTaChmenT7
6Cutandshapethepolypropylenecablexationsandinsertthecablehousingintothechannels.
Drillholescorrespondingtothediameterothetubularrivetsorscrews(seenextparagraph).
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FIxaTIOn OF The hOOk Cable aTTaChmenTs8
4Tenishedhookcableattachmentsareplacedinthesamepositionasontheplastermould.
Ontheorearmtheyarexedwithcountersunkheadsel-tappingscrews(d1=3mm,L=10mm).
4Onthetrans-humeralsocket,thehookcableattachmentisalsoplacedinthesamepositionasontheplastermould.
Fixtheattachmentwithtubularrivets(8x9mm).
Shouldthepositionotheattachmentshavetobechanged,warmthemwithaheatgunandmouldthemagainagainstthearmsocketororearm.
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shOuldeR haRness9
6Insertthebicyclebrakecableintothehousing.Ontheproximalpart,xawebbinghangerwithascrewclamp.Onthedistalpart,makealoopwiththecableandsecureitwithasmallmetaltube(clampsleeve),whichisfattened(pressed)aroundthecable.
6Tesimplesttypeoharnessoroperatingthehookisthegureoeightsuspension.
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4Foldthenylonbeltaroundtheoppositeshoulder.Teconnectionshouldbeadjustedinthemiddleotheback(spine).
4Stapleorclamptheharnesstogether.Whencuttingthebelt,leaveitalittlelongersothatitcanbereadjusted.
Checkwiththeamputeethatthecablecontrolsystemunctionsproperlyindierentarmpositions.
oopenthehook,thepatientmoveshisshoulderonthesoundside(oppositesideordoubleamputees)ortheprosthesisorward.
4
Oncetheharnesshasbeenadjustedsothattheamputeeeelscomortablewithit,sewthebeltconnectionandthexationontothewebbinghanger.
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4opreventraying,meltthebresattheendothebeltwithaweldingiron.
4Teharnessisconnectedtothewebbinghangerontheposteriorside,whiletheotherendisxed
totheanteriorwallwithatubularrivet.
Teelasticstrapenablestheamputeetoopenandclosetheworkinghook.
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6Otherharnessingsystems,suchasthoseproducedbytheOttoBockCompany,maybeused.
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FInIshed TRans-humeRal PROsThesIs10
4Nexttothehookorworkingring,acosmetichandorothertoolrequiredbythepatientmaybeattached(screwedon).
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ICRC Code DescriptionUnit ofmeasure
Quantity
OCPOELBOKIAOCPOELBOLIAOCPOELBOERA
*Elbow, adult*Elbow kits are available in three diferent colours. Choose ICRC code according to colour.**** Skin colour** Olive colour** Terra colour
One elbow kit comprises: Elbow unit Elbow cup with M6 T-nut Rubber joint, D70 x d6 x H3 mm PP wrist unit with M10 T-nut, dia. 45 mm Pan head Phillips raming screws 8 x 3 mm or wrist unit
Kit
EachEachEachEachEach
1
11114
OCPOHOOKAL
OCPOHOOKAR
KORTHOOKSP
*Hook, adult, let, stainless steel, M10 threadAccording to side o amputation
*Hook, adult, right, stainless steel, M10 thread*According to side o amputation
Spare parts or hook:Rubber washer, D30x d10x H6 mmStainless steel spring
Each
Each
EachEach
1
1
1010
OCPOHOOKKRT *Working round ring tool, stainless steel with rubber washer*On request by amputee
Each 1
OCPOHANDERMLOCPOHANDERMR
OCPOHANDERWLOCPOHANDERWR
Terra colour:Hand, man, let, terra colourHand, man, right, terra colour
Hand, woman/child, let, terra colourHand woman/child, right, terra colour
EachEach
EachEach
11
11
OCPOHANDKIMLOCPOHANDKIMROCPOHANDKIWLOCPOHANDKIWR
Beige colour:Hand, man, let, beige colourHand, man, right, beige colourHand, woman/child, let, beige colourHand, woman/child, right, beige colour
EachEachEachEach
1111
OCPOHANDLIMLOCPOHANDLIMROCPOHANDLIWLOCPOHANDLIWR
Olive colour:Hand, man, let, olive colourHand, man, right, olive colourHand, woman/child, let, olive colourHand, woman/child, right, olive colour
EachEachEachEach
1111
lit of copot, CR eqipt sa (CRe)
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ICRC Code DescriptionUnit ofmeasure
Quantity
MDREBANDP10
MDREBANDP12
Plaster bandages 10 cmorPlaster bandages 12 cm
According to stump dimension
OMIS Plaster o Paris According to cast dimension
OMIS Nails Each 4
OPLAEVAFERA03OPLAEVAFKIN03OPLAEVAFLIV03
EVA 3 mm, plastic sheet or other or extension tube Each 1, dimension according to TH socketextension length
OMIS Tubular nylon stocking, 60 or 80 mm or PP draping Each 1, length according to TH socket
OMIS Bicycle brake housing dummies with electric cable Each Length described in book cableattachments
OPLAPOLYCHOC04OPLAPOLYCHOC05
OPLAPOLYSKIN04OPLAPOLYSKIN05
OPLAPOLYLIV04OPLAPOLYLIV05
Polypropylene 4 or 5 mm according to patient size:Polypropylene 4 mm, terra brownPolypropylene 5 mm, terra brown
Polypropylene 4 mm, beigePolypropylene 5 mm, beige
Polypropylene 4 mm, olivePolypropylene 5 mm, olive
Each Dimension explained in PP drapingtechnique
OPLAPOLYCHOC03OPLAPOLYSKIN03OPLAPOLYLIV03
Polypropylene 3 mm or cable attachment dummies:Polypropylene 3 mm, terra brownPolypropylene 3 mm, beigePolypropylene 3 mm, olive
Each
OMIS Defnitive bicycle brake cable with housing Each 1, cut according to patient sizeOMIS Fixation or cable attachment on orearm:Countersunk head sel-tapping screws d1 = 3 mm,L = 10 mm
Each 4
OHDWRIVET081
Fixation or PP cable attachment on trans-emoral socketand harness:Tubular rivets 8 x 9 mm
Each 5
OMIS PP webbing hanger or other fxation method Each 1
OMIS
OCPOELBOHAR
Harness nylon (or other) belt (width 25 mm) with elasticstrap (width 25 mm)orHarness or upper limb prostheses
Each 1, length according to patient size
lit of otr fctri tri
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MISSION
The International Committee of the Red Cross (ICRC) is an impartial, neutral andindependent organization whose exclusively humanitarian mission is to protect thelives and dignity of victims of war and internal violence and to provide them withassistance. It directs and coordinates the international relief activities conductedby the Movement in situations of conict. It also endeavours to prevent suffering
by promoting and strengthening humanitarian law and universal humanitarianprinciples. Established in 1863, the ICRC is at the origin of the International RedCross and Red Crescent Movement.
Acknowledgements:
Jean Franois GallayLeo GasserPierre GauthierFrank JoumierJacques LepetitBernard Matagne
Joel NiningerGuy NuryPeter PoetsmaHmayak Tarakhchyan
and all prosthetists-orthotists who have worked in ICRC-assisted physical rehabilitation centres.
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0868/002
09/200
6
200
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Physical Rehabilitation Programme
trans-radial Prosthesis
Manufacturing guidelines
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International Committee of the Red Cross
19 Avenue de la Paix
1202 Geneva, Switzerland
T + 41 22 734 60 01 F + 41 22 733 20 57
E-mail: [email protected]
www.icrc.org
ICRC, September 2006
All photographs: ICRC/PRP
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T of cott
Foreword 2
Introduction 41.Castingandrectication 4
2.Positioningthewrist 5
3.Polypropylenedrapingorstsocket 7
4.Productionosecondsocket 9
5.Positioningocablehousing 9
6.Polypropylenedrapingosecondsocket 10
7.Fixationocablehousing 12
8.Cablecontrolsystem(harness) 14
9.Fitting 17
Listocomponents,CREquipmentsSA(CRE) 19
Listoothermanuacturingmaterials 20
Manuacturing Guid el ines Trans-Rad ial P rosthesis
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28/48 ICRC P hysical Rehab i l i tat ion P rog ramme
Foror
T ICRC poprop tcoo
Sinceitsinceptionin1979,theICRCsPhysicalRehabilitationProgrammehaspromotedtheuseotechnologythatisappropriatetothespeciccontextsinwhichtheorganizationoperates,i.e.,countriesaectedbywarandlow-incomeordevelopingcountries.
Tetechnologymustalsobetailoredtomeettheneedsothephysicallydisabledinthecountriesconcerned.
Tetechnologyadoptedmustthereorebe:
durable,comortable,easyorpatientstouseandmaintain; easyortechnicianstolearn,useandrepair; standardizedbutcompatiblewiththeclimateindierentregionsotheworld; low-costbutmodernandconsistentwithinternationallyacceptedstandards; easilyavailable.
Techoiceotechnologyisogreatimportanceorpromotingsustainablephysicalrehabilitationservices.
Forallthesereasons,theICRCpreerredtodevelopitsowntechniqueinsteadobuyingready-madeorthopaediccomponents,whicharegenerallytooexpensiveandunsuitedtothecontextsinwhichtheorganizationworks.TecostothematerialsusedinICRCprostheticandorthoticdevices
islowerthanthatothematerialsusedinappliancesassembledromcommercialready-madecomponents.
WhentheICRClauncheditsphysicalrehabilitationprogrammesbackin1979,locallyavailablematerialssuchaswood,leatherandmetalwereused,andorthopaediccomponentsweremanuacturedlocally.Intheearly1990stheICRCstartedtheprocessostandardizingthetechniquesusedinitsvariousprojectsaroundtheworld,orthesakeoharmonizationbetweentheprojects,butmoreimportantlytoimprovethequalityoservicestopatients.
Polypropylene(PP)wasintroducedintoICRCprojectsin1988orthemanuactureoprostheticsockets.Terstpolypropyleneknee-jointwasproducedinCambodiain1991;othercomponents
suchasvariousalignmentsystemswererstdevelopedinColombiaandgraduallyimproved.Inparallel,adurableoot,madeinitiallyopolypropyleneandEthylVinylAcetate(EVA),andnowopolypropyleneandpolyurethane,replacedthetraditionalwooden/rubberoot.
In1998,aercareulconsideration,itwasdecidedtoscaledownlocalcomponentproductioninordertoocusonpatientcareandtrainingopersonnelatcountrylevel.
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Ojctiv of t
TeICRCsManuacturingGuidelinesaredesignedtoprovidetheinormationnecessaryorproductionohigh-qualityassistivedevices.
Temainaimsotheseinormativemanualsareasollows:
opromoteandenhancestandardizationoICRCpolypropylenetechnology; oprovidesupportortrainingintheuseothistechnology; opromotegoodpractice.
Tisisanothersteporwardintheeorttoensurethatpatientshaveaccesstohigh-qualityservices.
ICRCAssistanceDivision/HealthUnitPhysicalRehabilitationProgramme
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30/48 ICRC P hysical Rehab i l i tat ion P rog ramme
Itroctio
Teaimothisdocumentistodescribeamethodorproducingtrans-radial prostheses withinterchangeable sockets,workingwiththeICRCpolypropylenetechnologyandorthopaedic
componentsusedattheRegionalPhysicalRehabilitationCentreinBattambang,Cambodia.
Tecasting,recticationandalignmentmethodsusedcorrespondtointernationalprostheticandorthotic(P&O)standardsopracticeandarethereorenotdescribedintheseICRCmanuacturingguidelines.
CasTIng and ReCTIF ICaTIOn1
4Patientassessment,castingandrecticationopositivecastimpressionsareperormedinaccordancewithP&Ostandards.
4Alignmentlinesantero-posteriorandmedio-lateral(A-P,M-L)aredrawnonthepositivemouldorproperpositioningothewrist.Inmostcasesthiswillbealongthecentralaxisothetrans-radialstump.
Drivenailsintothedistalendothecasttoensuregoodadherenceorthebuild-upotheplasterextension.
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POsITIOnIng The wRIsT2
4MakeaconicalextensiontubeusingEVA,plasticsheetingorsomeothersuitablematerial
andplaceitaccordingtothealignmentlinesorwristpositioning.apetheconeinplace.
Filltheextensionconewithplasterupto5mmhigherthanthelevelothewrist,soastoleaveroomorshapingthecorrectanglesothewrist.
4Prolongtheproximalalignmentlinesalongtheplasterextensioninordertoacilitatepositioningothepolypropylenewrist.
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4Smoothandshapethebuild-upsothatitisperectlyconical,otherwiseitwillbedicultto
exchangethesocketsinthistechnique.
4Temeasurementromtheolecranontotheradialstyloidprocessothesoundsidewilldeterminethelengthotheprosthesistothedistalendothewristunit.
Telengthotheprosthesismaybe1to2cmshorterthanthesoundside,butneverlonger.
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2
1
3
Manuacturing Guid el ines Trans-Rad ial P rosthesis
POlyPROPylene dRaPIng OF FIRsT sO CkeT3
4
Measurementopolypropylenesheet:
Wristcircumerence+2cm Epicondylecircumerence+4cm Lengthoplastercast+15cm
Tickness3or4mm,dependingonpatient.
4Beoredrapingthepolypropylenesheet,pullastockingovertheplastermould.Cutitatthe
proximalpartothewristandxitwithcontactglue.Dustthestockingwithtalcumpowder.
4Heatthepolypropyleneinan
ovenorabout20minutesat180C.
Drapethepolypropyleneovertheplastermodelandstickthesidestogetheralongtheposteriorside.ightenthepolypropylenearoundthesuctionconeortubeusingabicycleinnertube,ropeorstocking,thenopenthe
vacuumvalve.
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4Usingscissorsoraknie,cutotheleoverpolypropyleneotheweldingseamwhileitisstillhot.
Keepthevacuumonuntiltheplastichascooleddown.
4Removetheplaster,shapethesockettrimlinesandgrindtheposteriorweldingseam.
Drillahole(dia.20mm)onthemedial/distalsideorpullingthestumpsocket.
Flattenthepolypropyleneonthedistalendothewrist.
Checkthesocketontheamputee
orcomort,suspensionandlength.
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POsITIOnIng OF Cable hOusIng5
4Drawalineromtheproximaltothedistalpartonthemid-anteriorothesocket.Te line must stop at least5 cm from the wrist.Tisindicatesthepositionorthecablehousingdummy.
4akeabicyclebrakecablewithhousing,cutitinaccordancewiththelengthothelineandxitonthestockingwithcontactglue.
PROduCTIOn OF seCOnd sOCkeT4
6Aerthersttting,llthesocketwithplasteragainandprepareitordrapingthesecondsocket.Pull4cottonstockinettubesand1nylonstocking(toobtainasmoothsurace)overtherstsocket.
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POlyPROPylene dRaPIng OF seCOnd sOCkeT6
4Heatastripopolypropyleneandshapeittothesocket,1cmabovetheplannedtrim
linesothe2ndsockettoavoidfaringatthetrimmededgesothissocket.Tiswillalsoprotectthe1stsocketwhenthesecondoneisbeingcut.
4Drapea3mmpolypropylenesheetoverthesocket,usingthesamemeasurementsanddrapingtechniqueasorthe1stsocket.
Whenthepolypropyleneiscool,cutitonthestripwithanoscillatingsaworhacksaw.
4Removethe2ndpolypropylenesocketandtheplasterinsidethe1stsocket.
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6Tetrimlinesothe2ndsocketshouldbeapproximately3cmdistaltothetrimlinesotheanteriorsideothe1stsocket,andshoulddip6cmintheposteriortocreateears/wingsonthemedialandlateralsides.
Tiswillpreservesomefexibilityorthe1stsocketandpreventrotationothe2ndsocket.
rimothedistalendbythewrist,leavingitfushwiththelengthothe1stsocket.
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FIxaTIOn OF Cable hOusIng7
4Removethecablehousingdummywithlongfatnosepliersoranawl.
4Cutanddrillopeningsintheendsothechannelcreatedbythecablehousing.
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4Insertthedenitivecablehousingandpushitinsidethechannelwitharivetingbar.
4Tecablehousingshouldextendatleast2cmoutsidethedistalchannelopeningtoprotectthecablewirerombendingandbreaking,andtoallowenoughroomorthecabletoopenthehookully.
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4Temostsimpletypeoharnessoroperatingthehookisthegureoeightsuspension.
Stapleorclampanylonbelt(30mmwide)onthewebbinghanger.
Cable COnTROl sysTem (haRness)8
4Insertthebicyclebrakecableintothehousing.Ontheproximalpart,xapolypropylenewebbinghangerwitha
screwclamp.Onthedistalpart,makealoopwiththecableandsecureitwithasmallmetaltube(clampsleeve),whichisfattened(pressed)aroundthecable.
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4Foldthenylonbeltaroundtheoppositeshoulder.
Teconnectionshouldbeadjustedinthemiddleotheback(spine).
4Stapleorclamptheharnesstogether.Whencuttingthebelt,leaveitalittlelongersothatitcanbereadjusted.
Checkwiththeamputeethatthecablecontrolsystemunctionsproperlyindierentarmpositions.
oopenthehook,thepatientmoveshisshoulderonthesoundside(oppositesideordoubleamputees)ortheprosthesisorward.
6Oncetheharnesshasbeenadjustedsothatamputeeeelscomortablewithit,sewthebeltconnectionandthexationontothewebbinghanger.
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4opreventraying,meltthebresattheendothebeltwithaweldingiron.
4Finishedprosthesiswithinterchangeablesocket.
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FITTIng9
4Terstsocketcanbeusedwithacosmetichand,aworkingringorothertoolsnotrequiringthecable
controlsystem.
4Checkwiththeamputeethatthesecondsocketslideseasilyovertherst.
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4eachthepatienthowtousetheinterchangeabletrans-radialsocketsandhowtoconnectandusetheharnessandthecable-operatedhook.
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ICRC Code DescriptionUnit omeasure
Quantity
OCPOWRISKIAOCPOWRISLIAOCPOWRISERA
PP wrist unit, adult, with M10 T-nut (dia. 45 mm) and 4 pan head Phillips ramingscrews, 8 x 3 mm* Wrist units are available in 3 diferent colours. Choose ICRC code according to colour **** Beige colour** Olive colour** Terra colour
Each 1
OCPOHOOKAL
OCPOHOOKAR
KORTHOOKSP
Hook, adult, let, stainless steel, M10 threadAccording to side o amputation
Hook, adult, right, stainless steel, M10 threadAccording to side o amputation
Spare parts or hook:
Rubber washer, D30x d10x H6 mmStainless steel spring
Each
Each
EachEach
1
1
1010
OCPOHOOKKRT * Working round ring tool, stainless steel with rubber washer* On request by amputee
Each 1
OCPOHANDERMLOCPOHANDERMROCPOHANDERWLOCPOHANDERWR
Terra colour:Hand, man, let, terra colourHand, man, right, terra colourHand, woman/child, let, terra colourHand woman/child, right, terra colour
EachEachEachEach
1111
OCPOHANDKIMLOCPOHANDKIMR
OCPOHANDKIWLOCPOHANDKIWR
Beige colour:Hand, man, let, beige colourHand, man, right, beige colour
Hand, woman/child, let, beige colourHand, woman/child, right, beige colour
EachEach
EachEach
11
11
OCPOHANDLIMLOCPOHANDLIMROCPOHANDLIWLOCPOHANDLIWR
Olive colour:Hand, man, let, olive colourHand, man, right, olive colourHand, woman/child, let, olive colourHand, woman/child, right, olive colour
EachEachEachEach
1111
lit of copot, CR eqipt sa CRe
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ICRC Code DescriptionUnit omeasure
Quantity
For frst TR socket:
MDREBANDP10
MDREBANDP12
Plaster bandages 10 cmorPlaster bandages 12 cm
Each According to stump dimension
OMIS Plaster o Paris According to cast dimension
OMIS Nails Each 2
OPLAEVAFERA03OPLAEVAFKIN03OPLAEVAFLIV03
EVA 3 mm, plastic sheet or other or extension tube Each 1, dimensions according to extensionlength
OMIS Tubular nylon stocking, 60 or 80 mm or PP draping Each 1, length according to prosthesis
OPLAPOLYCHOC03OPLAPOLYCHOC04
OPLAPOLYSKIN03OPLAPOLYSKIN04
OPLAPOLYLIV03OPLAPOLYLIV04
Polypropylene 3 mm or 4 mm according to patient size:Polypropylene 3 mm, terra brownPolypropylene 4 mm, terra brown
Polypropylene 3 mm, beigePolypropylene 4 mm, beige
Polypropylene 3 mm, olivePolypropylene 4 mm, olive
Each Dimension explained in PP draping
For second TR socket:
MDREBANDP10 Plaster bandage 10 cm Each According to frst socket size
OMIS Plaster o Paris According to frst socket size
ODROSTOCOT60 Cotton stockinet 60 mm or PP draping Each 4 , length according to prosthesis
OMIS Nylon stocking or PP draping Each 1, length according to prosthesis
OMIS Bicycle brake cable housing dummy Each 1, cut according to socket length
OPLAPOLYCHOC03OPLAPOLYSKIN03OPLAPOLYLIV03
Polypropylene 3 mm or trim line strip:Polypropylene 3 mm, terra brownPolypropylene 3 mm, beigePolypropylene 3 mm, olive
Each 1, width: 20 mm, according tocircumerence
OPLAPOLYCHOC03OPLAPOLYSKIN03OPLAPOLYLIV03
Polypropylene 3 mm or 2nd socketPolypropylene 3 mm, terra brownPolypropylene 3 mm, beigePolypropylene 3 mm, olive
Each Dimensions explained in PP drapingo 2nd socket
OMIS Defnitive bicycle brake cable housing Each 1, cut according to socket length
OMIS Bicycle brake cable Each 1, length according to patient size
OMIS PP webbing hanger or other fxation method Each 1
OSBOVSB24 Nylon (or Perlon) belt or harness, width 25 mm Each 1, length according to patient size
lit of otr fctri tri
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MISSION
The International Committee of the Red Cross (ICRC) is an impartial, neutral andindependent organization whose exclusively humanitarian mission is to protect thelives and dignity of victims of war and internal violence and to provide them withassistance. It directs and coordinates the international relief activities conductedby the Movement in situations of conict. It also endeavours to prevent suffering
by promoting and strengthening humanitarian law and universal humanitarianprinciples. Established in 1863, the ICRC is at the origin of the International RedCross and Red Crescent Movement.
Acknowledgements:
Jean Franois GallayLeo GasserPierre GauthierFrank JoumierJacques LepetitBernard Matagne
Joel NiningerGuy NuryPeter PoetsmaHmayak Tarakhchyan
and all prosthetists-orthotists who have worked in ICRC-assisted physical rehabilitation centres.
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