Who is a Candidate for an Electronic Prosthesis?

The latest developments in advanced technology prostheses generate a considerable amount of excitement in the limb loss community. From a bionic arm to an electronic hand, the newest prostheses increasingly offer benefits such as greater comfort, efficiency, and a more lifelike appearance. While these devices can show promise in helping many people, especially younger individuals such as child amputees or young people with congenital limb deficiencies, each case must be considered individually. Not every technique is an appropriate treatment for a traumatic amputation or a limb deficiency from birth. The following are a few of the factors should be taken into consideration when determining whether a child is a good candidate for an electronic prosthesis:

• Age of the child. Between the ages of 3 and 7 months, children with upper extremity amputations or congenital birth deficiencies may be ready for upper-limb prostheses. Later, between the ages of 9 and 16 months, when children begin to stand, they may be ready for lower-limb prostheses. Once children begin to reach a certain level of neuromuscular potential and perform more complex functions such as walking, between the ages of 1 and 2, a more functional prosthesis such as a myoelectric prosthesis may be needed.
• Length of the deficient limb. If the deficient limb does not allow enough room for an electronic prosthesis, it may be a contraindication. A longer-than-necessary prosthesis could cause problems for the user.
• Child’s cognitive skills. Because learning how to use myoelectric prostheses require sufficient cognitive skills, children with mental challenges may not be suited for this type of prosthesis.
• Family psycho-social dynamics. According to a study of infant prosthetic fittings, lack of parental support and participation can have a very strong influence on whether or not children accept their prostheses. For many parents, their own acceptance of the prosthesis is often related to appearance. As a myoelectric prosthesis more closely resembles birth-given limbs, many elect for this option.

In addition, factors such as cost can influence the decision to pursue an electronic prosthesis. Even for parents with health insurance, clauses that limit the number of prosthesis that may be covered in an individual’s lifetime or insufficient coverage limits for prostheses can prohibit them from considering electronic prostheses. Luckily, the Children’s Electronic Hand Assistance Project can advise parents on additional sources for prosthetic funding, as well as provide insurance counseling to help parents analyze and interpret their health insurance policies. Further information about both of these services can be found at www.myoelectricprosthesis.com.