The History of Prosthetics: Past Present and Future

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The development of prosthetics has a long and varied history, from primitive beginnings in Ancient Rome to the up and coming 3D printing, the field of prosthetics has developed rapidly in a relatively short time period.

The first recorded prosthetic limb belonged to the Roman General Marcus Sergius. Pliny writes in his epic Natural History, written in A.D.77, about General Marcus Sergius who lost his hand in the Punic Wars, and had an iron prosthetic limb created for him. The limb was so effective that he was able to hold a shield and continue fighting. The historian D.E. Coulston highlights in Classical World (1976) that it is important to view sources critically, such as Pliny’s, as the sources he drew from to write his history were often gossip passed through aristocratic circles. With this in mind it’s worth noting a more interesting example of historical prosthetics in the form of Ancient Egypt. In 2000, archaeologists found the mummy of an Egyptian female noblewoman with a prosthetic toe. The prosthetic limb was made of wood, metal and was attached to the body by leather straps. This primitive design is worth exploring as its simple design is still used today as a base for many prosthetic limbs.

However, the first major advancement in the field of prosthetics came in the early 16th century with the French doctor Ambroise Paré who invented a hinged mechanical hand. He also created the first prosthetic leg in which the knees could lock. This was a significant development, as in the Dark Ages, legs had usually been made out of wooden stumps, and hands from hooks, therefore, this invention gave a greater flexibility of movement. In the 1690s Pieter Verduyn built on Paré’s invention by combining Paré’s lockable knee with his own creation of a leather cuff that could be more easily attached to the leg. These two designs form the basis for most prosthetics today.

It was not until the 1840s that huge advances in prosthetics could be made with the invention of gaseous anaesthesia. This was essential as it meant that longer, more intricate amputation surgeries could be performed. This meant that the limb could practically be prepared for the attachment of a prosthesis in the way that 16th century leather cuffs could not. At the same time medical advances were being made, with contributions from nurses such as Florence Nightingale. Nightingale contributed to understandings of how important having hygienic and sterile medical conditions were. This meant practically that more successful amputations were being made with a higher survival rate.

Some trail blazers such as Paré and Verduyn created valuable contributions to the field, it is fair to say that it wasn’t until the First and Second World Wars that more significant developments were made. Scientific research is often advanced by necessity and the World Wars developed a real need for efficient, cheap and effective prosthetic limbs. The American government set up the Artificial Limb Programme in 1945 and they funded a lot of research into prosthetics. This work was continued by John Sabolich into the 1980s in which lower extremity prosthetics saw a revival. Sabolich invented the Contoured Adducted Trochanteric-Controlled Alignment Method (CATCAM) socket. His socket was significant as previously sockets were made in a square shape, with no container for muscular tissue. His new designs helped because it helped lock the limb in place and distributed the weight evenly.

The 1990s also saw advances as the first microprocessor- controlled prosthetic knees became available. It was invented by Chas. A. Blatchford & Sons in 1993 and its aim was to make walking with prosthetics look more natural. Blatchford developed on his model throughout the 90s and significantly improved his 1993 model in 1998. The new limb was called the Adaptive Prosthesis. It used hydraulic controls and had a microprocessor that could respond to changes in walking speed; this was all helpful in making prosthetic limbs look more realistic.

New plastics and materials such as carbon fibre have been essential in creating lighter, stronger and more practical artificial limbs. Additionally, electronics have become very common in artificial limbs. An example of this would be Myoelectric limbs. These limbs convert muscle movements into electrical signals. Despite all these advances the functionality of prosthetic limbs remains limited. Up until now, prosthetic limbs were always removable and outside of the body. Therefore, for many people having amputations, their prosthetics felt alien. Interestingly, researchers at the Royal National Orthopaedic Hospital have created a new implant that responds to that, and have created an interfacing prosthesis that can be directly connected to your skeleton. This research is still in its embryonic stages however it has had a very promising start.

With more attention being drawn to the development of prosthetics, who knows what future research could emerge?

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