History of Orthotics and Prosthetics

A short history of the prosthetics devices that have helped us enrich peoples lives.

Well designed prosthetics deliver both functionality and are cosmetically pleasing, but it also serves to complete the amputee’s sense of wholeness. A prosthesis provides mobility as well as emotional comfort, and so the history of prosthetics is not only a scientific history, but the story of human beings since the dawn of civilization who by birth, wound, or accident were left with a missing limb.

The earliest example of a prosthesis ever discovered is not a leg, arm, or even a fake eye, it’s a toe. A big toe, belonging to a noblewoman, was found in Egypt and dated to between 950-710 B.C.E. We all know that toes are important, but it’s interesting that our earliest physical example of the history of prosthetics is a toe and not something that might seem more important, like a leg or an arm. The big toe was particularly important to an Egyptian because it was necessary in order to wear the traditional Egyptian sandals. Worn nearly 3,000 years ago, this toe is a representation of the history of prosthetics being as much about function as identity.

To show how little prosthetic limbs have advanced through most of history, consider the artificial hands and legs of the Dark Ages — nearly 2,000 years later. Armored knights of this era often relied on iron prosthetic limbs, usually crafted by the same metalworker who made their armor. These bulky limbs were admittedly not very functional and were actually used more for the purpose of hiding the lost limb, which was considered at the time to be an embarrassing deformity.

Most famously attributed to seafaring pirates, peglegs with wooden cores and metal hands shaped into hooks have actually been the prosthetic standard throughout much of history. While Hollywood has exaggerated their use of hooks and peglegs, pirates did sometimes rely on these types of prostheses. The required materials for these devices could be scavenged from a common pirate ship; however, a trained doctor would have been rare. Instead, the ship’s cook typically performed amputation surgeries, albeit with poor success rates.

Ambroise Paré: Father of the Modern Prosthetic Leg

Ambroise Paré was an accomplished barber/surgeon and anatomist who was the official royal surgeon for four French kings. He is regarded by many as the father of modern surgery.

Along with improving amputation techniques and survival rates during his time as a war surgeon, he developed functional prosthetic limbs for all parts of the body. He used his understanding of anatomy to design prosthetics that mimic the function of biological limbs.

He was the first to develop an above-knee prosthetic with an adjustable harness and a hinge-knee with lock control – both of which are still used today. He also transitioned away from wood in favor of much lighter prosthetics made of leather, paper, and glue.

Around 1690, a Dutch surgeon, Pieter Verduyn, later developed a lower leg prosthesis with specialized hinges and a leather cuff for improved attachment to the body. Amazingly, many of the advances contributed by these two doctors are still common features of modern day prosthetic devices.

Londoner James Potts invented an above-knee prosthetic in 1800 with a calf and thigh socket made of wood, and a flexible foot attached with catgut tendons to a steel knee joint. This design was not only more articulate than precious prosthetics but was considered more aesthetically pleasing.

This design emigrated to the U.S. in 1839 and was the standard leading up to the U.S. Civil War.

With the advent of gaseous anesthesia in the 1840s, doctors could perform longer, more meticulous amputation surgeries, allowing them to operate on the limb stump in such a way as to prepare it for interfacing with a prosthesis. Advances in sterile, germ free surgeries also improved the success rate of amputation procedures, increasing the need for prosthetic limbs.

As artificial limbs became more common, advances in areas such as joint technology and suction-based attachment methods continued to advance the field of prosthetics. Notably, in 1812, a prosthetic arm was developed that could be controlled by the opposite shoulder with connecting straps — somewhat similar to how brakes are controlled on a bike.

The National Academy of Sciences, an American governmental agency, established the Artificial Limb Program in 1945. The program was created in response to the influx of World War II veteran amputees and for the purpose of advancing scientific progress in artificial limb development. Since this time, advances in areas such as materials, computer design methods and surgical techniques have helped prosthetic limbs to become increasingly lifelike and functional.

Modern Prosthetics

The World Wars necessitated new advancements in prosthetic technology.

After World War I, the Surgeon General of the U.S. Army got the ball rolling on what would become the American Prosthetics and Orthotics Association. Despite this, there were no major advancements in prosthetics till post-World War II when the U.S. government provided funding to military companies to improve the form and function of prosthetics. This led to many of the modern materials used in prosthetics such as plastic, aluminum, and other composite materials.

Also noteworthy was the invention of the suction sock for above-knee prosthetics at UC Berkeley in 1946.

In 1975, Mexican American inventor Ysidro M. Martinez invented a below-knee prosthetic to help improve gait problems associated with prosthetics of the time. His design had a high center of mass and was lightweight to reduce friction and pressure and allow for acceleration and deceleration.

Thanks to the passion of prosthetic pioneers, today we are closer than ever to replicating the full function of a biological limb.

Blade prostheses allow amputee athletes to sprint. Microprocessor knees allow a prosthetic to adapt its flexion and extension for different environments.

With the advancement of neuroprosthetics and fully-realized brain-controlled devices, we have never been closer to the dream of fully replacing a missing limb.

Source: https://synergypo.com/blog/a-short-history-of-prosthetics/