Original: Wang Yong
Prosthetic limb is one of the most important assistive devices for the physically disabled, which can help them to work, study and live like normal people. So how are artificial limbs made? Let’s look at a set of pictures first:
Take the leg prosthesis as an example. First, a plaster bandage should be wrapped around the end of the stump to take shape.
Secondly, take off the plaster bandage and it will become a negative type, and then adjust the negative type according to the patient’s situation.
Thirdly, pouring gypsum into the female mold to form the male mold. Similarly, the male type should be adjusted.
Fourth, with a male mold, you can make an inner sleeve (soft material to protect the part in contact with the prosthesis).
Fifth, make a receiving cavity (where the stump is inserted, use strong materials such as resin).
Sixth, assembly (the receiving cavity, joints, foot plates, etc. are assembled together).
Seventh, test, adjust and shape.
Whether it looks simple or not, it is actually very complicated. Then, how can people with physical disabilities get funding and install artificial limbs? In mid-July, the reporter of Public Welfare Times went to Qinghai to fit prostheses for local disabled people with the help of the implementation team of the prosthetic orthopedic adaptation rescue project of the China Welfare Foundation for the Disabled, and learned about related issues.
Personalized adaptation
On the morning of July 10th, 55-year-old Zhao Changqing finally met Liu Jinsong, director of the Orthopedic Department of Beijing Bo ‘ai Hospital, China Rehabilitation Research Center, who came to fit his prosthesis.
As a teenager, Zhao Changqing, who was accidentally crushed to the leg by a train and had his left calf amputated, has been fitted with a prosthetic for several years, but it has not been replaced because of financial difficulties at home. In order to reduce the wear and tear, Zhao Changqing had to wrap the rest of his left leg in layers of cloth, and then wear artificial limbs.
Liu Jinsong carefully examined the condition of Zhao Changqing’s left stump. "There is too little left in the calf, it is not easy to exert force, it is more difficult to drive the prosthesis, and the end is not able to bear the weight. It is more complicated than I knew before. " Liu Jinsong said.
After discussion, Liu Jinsong team decided to assemble the left kneeled leg prosthesis for Zhao Changqing.
According to Liu Jinsong, the situation like Zhao Changqing is not uncommon. Every disabled person’s limb disability is different, and there is no universal standard type prosthesis to use, which needs personalized adaptation.
"Because the situation of each disabled person is different, every step of making artificial limbs requires the staff to make detailed adjustments." Liu Jinsong stressed.
Disabled people with artificial limbs also need to be familiar with the use of artificial limbs through a certain period of rehabilitation training. "It takes about two weeks to wear a prosthetic, and it takes more than a month to wear it." Liu Jinsong said.
Participation of social forces
According to Liu Jinsong, due to the high technical requirements and the high corresponding costs, many disabled people cannot make such personalized prosthetic adaptation. Zhao Changqing was able to get such an opportunity, thanks to the development of the prosthetic orthopedic adaptation rescue project of the China Welfare Foundation for the Disabled.
"We found in the preliminary investigation that there is almost no rehabilitation field in the public welfare projects of serious illness relief. At the same time, there are 24.72 million people with physical disabilities in China, and the demand for prosthetic adaptation is particularly great. As a welfare foundation for the disabled, we have advantages in this field, so we discussed with the China Rehabilitation Research Center the launch of a prosthetic orthopedic adaptation rescue project. " Chang Da, deputy director of the Publicity Department of China Disabled Welfare Foundation, said.
The project was initiated by the China Welfare Foundation for the Disabled and implemented by the China Rehabilitation Research Center. Through the network of rehabilitation centers and communities in various provinces and cities across the country, poor limb patients were screened for prosthetic orthopedic adaptation surgery, and through later professional rehabilitation training, they were enabled to have basic working ability and independent life.
According to Liu Jinsong, generally speaking, the project insists on providing help to disabled people with poor families. "Children are given priority, the pillars of the family are given priority, the technical requirements are higher, and the priorities that cannot be done locally."
The recipients can go to China Rehabilitation Research Center in Beijing for adaptation, and China Rehabilitation Research Center will also go to local areas for adaptation according to the situation. "On the one hand, it can reduce the burden on patients, on the other hand, it can communicate with local technicians to promote the level of local prosthetic adaptation." Liu Jinsong said.
According to Changda, the project was launched in 2016 and has been implemented for four years, raising more than 10 million yuan through the Internet.
In 2019, the project expert group plans to go deep into poverty-stricken areas in western China, such as Xizang, Ningxia and Qinghai, and carry out rescue screening, with the goal of rescuing 48 patients in the above areas.
The project rescue work in Qinghai began three months ago. The Department of Prosthetics and Orthopedics of China Rehabilitation Research Center and Qinghai Provincial Rehabilitation Service Center for the Disabled jointly carried out the screening work for the aided patients, and 13 patients were screened out.
After the relevant application materials have been approved by the China Welfare Foundation for the Disabled, the China Rehabilitation Research Center will send an expert group to conduct on-the-spot inspection, measurement and selection, production, adaptation and adjustment, training and guidance for the patients. It is planned to complete the assembly of 13 aided patients (17 prostheses) in 3 to 4 weeks.
Integrate into social development
Although the scale of disabled people who have finished assembling artificial limbs through the project is not too large at present, the effect is very obvious-with artificial limbs, disabled people can work like ordinary people and even start businesses. One-legged courier brother Li Hongjun is one of them.
Li Hongjun, born in 1985, was raised by his uncle when his mother died at the age of 4. Before graduating from primary school, Li Hongjun set foot on the society. At the age of 17, he lost his right leg because of an accident on the construction site. After the operation, Li Hongjun returned to junior high school to continue his studies. When he graduated from junior high school, he was already 20 years old.
After graduation, Li Hongjun worked as a worker, an actor in a disabled art troupe, opened a newsstand and delivered a courier. The days when the courier was delivered were very difficult for Li Hongjun. "The main reason is that it is inconvenient to move, and the movement is much slower." What he is most afraid of is to send large goods, because his legs and feet are inconvenient for one person to move.
In 2017, Li Hongjun, who received assistance from the prosthetic orthopedic adaptation rescue project, came to China Rehabilitation Research Center. China Rehabilitation Research Center sent an expert team composed of orthopedic surgeons, prosthetic engineers and rehabilitation therapists to consult him, discuss and formulate the configuration plan, and finally adapt the prosthesis for him.
After several weeks of rehabilitation training, including simple weight bearing, center of gravity shifting, walking inside the bar, walking outside the bar, going up and down stairs, breaking up and down, walking on complicated outdoor roads, etc., Li Hongjun finally walked step by step from not being able to use artificial limbs to being able to walk on crutches and finally walking without crutches.
With the help of artificial limbs, Li Hongjun is more confident. When he first started delivering express delivery, his greatest wish was to have a courier store. In 2018 "double 11", the courier station jointly operated by Li Hongjun and his friends finally opened.
Talent cultivation is a big problem.
The role of prosthetic orthopedic adaptation in the fields of helping the disabled and tackling poverty is undoubtedly very important, but there are still many problems to be solved in order to promote it on a large scale.
First, the funding problem remains to be solved. Compared with congenital heart disease, leukemia and other serious diseases, the urgency of prosthetic adaptation is not so strong. It is difficult to raise funds when raising funds publicly on the Internet, and few charitable organizations launch such projects. The China Welfare Foundation for the Disabled can only solve a limited number of problems.
"We hope to make this project a brand and build a rescue fund pool through fundraising." Chang Da said.
Second, there is a shortage of professionals and equipment. As mentioned earlier, prosthetic adaptation needs to be handled one by one, "equivalent to the difference between ready-made clothes and customization." Liu Jinsong said that, therefore, a large number of professionals are needed, but there are very few prosthetics and orthotists in China and few training institutions.
According to Liu Jinsong, there are more than 2,000 prosthetic orthopedic institutions in Germany with a population of 80 million, but there are no specialized prosthetic orthopedic rooms in some provinces in China.
"When we go to local areas to carry out projects, we bring our own materials and borrow local equipment, but in many places, the technical accessibility is not enough and our staff need to develop them on the spot. Despite this, the requirements are the same, and we emphasize that the staff should have the spirit of artisans. " Liu Jinsong stressed.
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