What position does thumb have a lot of anatomical functionality?
Anatomical Hand Function
Tip hand position
Active TD
- Body Powered
- External Powered
Passive TD
- Passive device has to have function
- Aesthetic restorations
- Opposition Posts
- Pediatric Designs
- Sports and Recreational Adaptations
does not have to move or articulate for it to be useful
What is the most commonly used active TD?
Active Terminal Devices
Body power, voluntary opening, hook
Body Power, Voluntary Opening, Hook
Active Terminal Devices
- works well for large amounts of users
- when user pulls on BP cable, thumb opens tines
- rubber band closes
- ease of operation and learning to operate
What is the pinch force of 1 rubber band?
Active Terminal Devices
1.5 lbs of pinch at tip of TD
How many lbs of pinch force is adequate for most ADLs
Active Terminal Devices
3 lbs of pinch force
5 Steel
Body Power, Voluntary Opening, Hook
- # 5 most commonly used
- two nonsymmetrical tines that are canted
- no coating or lining
How does canting affect a TD?
Body Power, Voluntary Opening, Hook
- allows for good visibility for picking up objects
- limited in picking up very small objects
5XA
Body Power, Voluntary Opening, Hook
- X: Nitrile lined fingers
- A: Aluminum
- ribber coating used to inc friction for grasping objects
- Half weight: can be the difference between wearing and not wearing px
5X
Body Power, Voluntary Opening, Hook
- standard
- ~5 inch in build height
smaller # = larger terminal device
Benefit of Voluntary Opening
Body Power, Voluntary Opening, Hook
- remained closed under force of rubberband
- type of grasp requires no active thought or motion
Lyre Opening
Body Power, Voluntary Opening, Hook
- large opening
- grasp cylindrical
- easier to grab smaller objects
- used on one side of bilateral amputation to provide different grasps
Work hook/Farmer’s Hook
Body Power, Voluntary Opening, Hook
- slightly longer
- specifically designed to handle tools
- only steel
- knife holder
- nail tack holder
Sierra 2-Load Hook
Body Power, Voluntary Opening, Hook
- load = pinch force
- force can be changed (gentle or firm pinch force)
- removable and indep. replaceable tines
- limitations: weight & size
About
Body Power, Voluntary Closing, Hook
- @ rest without any force applied by the pt, the td will be in opening position
- when force applied, the td will close
Benefits
Body Power, Voluntary Closing, Hook
- work envelope is larger
- user has ability to grasp object in different positions or locations
- voluntarily control pinch force
- graded prehension
Limitations
Body Power, Voluntary Closing, Hook
- requires active grasp to maintain closure of tines
- holding something for a long time can be tiring and require a lot of attention
APRL
Body Power, Voluntary Closing, Hook
- Army Prosthetics Research Laboratory
- thumb is on ulnar side
- automatic lock; manual unlock
- choose between two different openings (small and large)
- heavy, delicate, mostly for satisfied propr users
Body Power, VO & VC, Hands
Active Terminal Devices
- Biggest advantages is appearance
- some grasp and release
Opposition Post
Passive Terminal Devices
- opposed directly by residual hands
- allow partial hand to be in flexion and extension
- can be positioned at greater angle
- can be folded against forearm out of the way
Pediatric Designs
Passive Terminal Devices
- MITT: Fingers not separated; most common
- in fist: allow child to crawl
- sports specific: rounded to hold ball or other round object
Terminal Devices
Practioner reported use
- 57% use body powered
- 34% use externally powered
- 9% use activity specific/passive
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WK1: UL Amputation Principles, Statistics, and Terminology14
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WK1: UL Amputation Surgery, Evaluation, and Anatomy20
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WK1: ULP Body Powered Control18
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WK1: Design Principles6
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WK2: Terminal Devices23
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WK2: Wrist Components12
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WK2: TR Elbow Components6
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WK4: Socket Design & Suspension22
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WK4: External Power Control9
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WK7: Elbow and Shoulder Joint10
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WK7: TH Nomenclature and Socket Design16
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WK8: Force and Excursion13
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WK8: TH Harness and Dual Control9
