by Samantha Barnes

Advances in Artificial Limbs Give Patients a New Lease on Life

“Put your best foot forward!” we say. There is nothing wrong with wishing someone well, but what if someone has lost the use of their limb or limbs and, in a worst-case scenario, amputation has to be done? What most of us take for granted – our mobility –suddenly becomes a whole new ball game.

Every day, countless people worldwide are fitted with an artificial limb. Losing a limb is anyone’s worst nightmare. Those of us who are able-bodied barely give a thought to the wonderful freedom we have been granted to walk, dance, run, climb, swim, get around, and move it all about. We even jump for joy!

Jaco Deist is faced, on a daily basis, with assisting people in adapting to this new reality by helping them to regain their mobility after losing a limb. Jaco graduated with a Diploma in Medicine in Orthotics and Prosthetics, followed by a BTech degree. Prosthetics is the name given to the branch of surgery that deals with prosthesis, the word used for replacing a missing body part with an artificial part.

Jaco has been in private practice for 20 years and finds it an amazing profession. “It sounds corny, but you can really make a difference in somebody’s life!” he says. “Many people are down in the dumps after the news of an amputation, or after a traumatic amputation, and to get them at that point and to work with them from beginning to end and to fulfil your promise to them, and to see how they are getting integrated back in society, is amazing.”

Justifiably, his clients are very appreciative of what has been done for them, especially when many of them thought they could never walk again. “To see somebody happy again, and you were part of it, is great!” Jaco reflects. “Working with kids is even better, as they just continue to live life as if nothing is wrong, and one has the opportunity to build long and lasting relationships with them!”

With advances in science come advances in artificial limbs. The leading companies and countries in terms of this are Ossur in Iceland and Otto Bock in Germany. These countries started research and development in prosthetics many years ago. Jaco confirms that Iceland and Germany spend massive amounts in testing new componentry, and have good financial support and enormous factories where all the tests and manufacturing take place. “They are light years ahead of South Africa,” he says.

For as long as people have been around, there has been a need for prosthetics. Prosthetics is not a new branch of medicine and has been in existence for thousands of years. The oldest known example of a prosthetic device is a wooden toe that was found attached to an Egyptian mummy’s foot.

Weight Loss in an Unconventional Sense
In the past 15 years, there have been great improvements in artificial limbs in terms of the materials used and their durability. “Weight has come down considerably,” Jaco says. “With materials like carbon fibre, they are able to manufacture lighter and thinner, but stronger products.”

It is in the area of lower-extremity prosthetics like prosthetic knee joints that massive technology advancement has taken place, specifically in respect of pneumatic and hydraulic cylinders and microprocessor knee units. “The knees are faster, more responsive and safer and they are trying to get closer to the human knee joint,” Jaco explains.

Prosthetic feet are not made from rubber or wood anymore. They consist of carbon fibre layers for what is termed ‘energy return’ feet. “The more you put in, the more you will get out,” Jaco says. “Shock absorbers and rotators are also included to make sport and long-distance walking easier.”

Advances in technology have also resulted in improvements to artificial limbs in the upper extremities. Arms now have myoelectric componentry. This picks up electrical impulses from the residual limb to open and close the hand or to lift the elbow. Jaco confirms that, prior to this new technology, all this was done with cables.

Patients who are frail are also reaping the benefits of advances in artificial limbs. “Products are lighter and safer to protect them and to prevent them from falling,” Jaco reveals. They are also able to purchase less expensive products, as their needs are less demanding in terms of what they need to be able to do with their prosthesis. What is good to hear is that children are benefitting from the fact that much prosthetic componentry is specifically designed with children in mind. Such examples include silicone liners, prosthetic knees, and different models of feet.

Change is the Name of the Game
Human beings truly are unique, and no less so when selecting an appropriate artificial limb. One size does not fit all. The prosthetist has umpteen factors to consider when doing a consultation. These include the patient’s financial means, their weight, amputation level, reason for amputation, length of residual limb, and needs, as well as their sports and hobbies. Other considerations include their age, general health, whether cosmetics is a concern, and their strength. Even the appearance of the residual limb is taken into account in terms of being bony, flabby, conical, long or short.

Instead of all these elements being a drawback to inspiring advances, they are a motivating factor. “I think that is exactly the challenge and that is what inspires us, keeps it interesting and always a challenge. We consistently have to change and redesign to meet all the new and different challenges,” Jaco explains.

The Real Heroes and Heroines
Those who have to go through the ordeal of an amputation and prosthetic limbs could not do it without the commitment of their medical team, family and friends. They also need heaps of courage and determination.

Orison Swett Marden succinctly describes what it takes to face your fears. “Obstacles are like wild animals. They are cowards but they will bluff you if they can. If they see you are afraid of them, they are liable to spring upon you; but if you look them squarely in the eye, they will slink out of sight.”

Jaco has had many cases over the years where patients have looked fear squarely in the eye and, as a result, their rehabilitation has been a success. In the words of Jaco: “Amputations and prosthetic limbs are usually associated with images of heartbreak, pain and broken dreams. But, every once in a while, we see proof that miracles do happen.”

Marcell Blignaut’s story is one such example This young man was in a near fatal motorcycle accident. His left leg was badly injured and, unfortunately, there was no possible way that doctors could save it. He had multiple injuries and, after his amputation, all care was devoted to keeping him alive.

Marcell was under sedation for a couple of weeks before being woken up and being told he had lost his leg. He was positive from the outset and extremely grateful to be alive. Jaco could see that Marcell’s positive attitude would enable him to make a success of his long rehabilitation process.

Before the accident, Marcell did rock climbing, kick boxing, quad biking and scuba diving. Despite the accident, Marcell is diving and riding quad bikes again. He has even received his black belt in kick boxing. Marcell has been rehabilitated to his full potential and is an inspiration to us all. People like Marcell are our unsung heroes.




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