Peek Behind the Curtain as Orthotic and Prosthetic Magic Happens

By Desmond Masterton, JJC Orthotic Prosthetic Technology Program

At Joliet Junior College the Orthotic Prosthetic Technology program educates and trains future technicians to fabricate orthoses and prostheses. We have a diverse population in our program, but one commonality is our students like to work with their hands and like to help people. Specialties within the medical field, both orthoses and prostheses restore function to a person with physical impairments so that they can return to an active lifestyle. Orthotics, also called braces, support and stabilize the spine or limbs that have decreased function due to trauma or pathology. Prosthetics, also called artificial limbs, replace the loss of upper or lower limbs.

Woman working on orthotics at JJC

Discover Orthoses and Prostheses at Abilities Expo Chicago

The most commonly used orthoses and prostheses used by people with physical impairments will be on display at Abilities Expo Chicago, June 25-27 at the Renaissance Schaumburg Convention Center. (Admission and parking are free and you can register here.) You will see ankle foot orthoses, knee ankle foot orthoses and spinal orthoses, as well as transtibial, transfemoral and upper limb prostheses…all forged in an orthotic prosthetic facility.

How are these Game-changing Assistive Technologies Created?

So, what does a technician do in the orthotic prosthetic profession? Technicians fabricate these interventions. But first, technicians need to be supplied with a shape of the existing body part, also called shape capture. It makes sense if you are required to build something you need to know what you are building around. Collaboration and communication are key.

Typically, the orthotic prosthetic clinician performs an impression process which involves applying a sock like interface over the limb or body part and marking specific anatomical structures on the sock. Then a series of measurements are performed and recorded on an orthometry form which is a standard in our profession. Picture a tailor making a suit.

Foot study for orthotics

After measurements are recorded, a plaster bandage is wrapped around the body part and allowed to harden, usually three-five minutes. The impression is then removed and all the landmarks that were identified and marked earlier are now transferred to the inside of the impression. Impressions may also be performed with an app on the clinicians' phone. S/he scans the phone around the limb of trunk and records a digital record which can then be emailed to a fabrication lab. The shape of the limb or trunk can then be made using CAD/CAM.

The technician then takes this impression and fills it with plaster and waits for it to harden, about twenty minutes. Then the impression is removed and what is left is the cast or positive model. The technician then performs cast model rectification and basically smooths the plaster to a renaissance smoothness. If the orthosis or prosthesis is to be made with plastic a sheet of plastic is placed into a special oven, heated, then draped and vacuum formed over the orthotic or prosthetic cast. Once it has cooled, the technician uses a cast saw to trim out the specific orthosis or prosthesis.

Instead of plastic, an orthosis or prosthesis may be made of a fiberglass material or carbon fiber. Which involves impregnating layers of material with a resin which then hardens and becomes the orthosis or prosthesis. Specific components such as knee joints, ankle joints or feet can then be added to the orthosis or prosthesis to customize it for the given client.

Building orthotics and prosethetics in class

Fabrication involves many hazardous materials, dangerous machines and sharp tools. Safety is of prime importance. The machines we use are very loud, so air plugs are a good thing to use to prevent hearing damage. Technicians will typically keep exposed skin covered, always wear safety goggles and gloves when handling chemicals. Certain rooms where chemicals are used will be vented outside to a filter. And the other good practice is to keep the laboratory clean.

Even after the orthosis or prosthesis is fabricated the technician will probably work on it again. Whenever adjustments are required, the clinician may direct the technician to make certain changes and modifications. We technicians work in a noble profession one that helps people with impairments get back to the life they want to lead.

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