Orthotics & Prosthetics | September 21, 2015 | Mark Lawson Bell

An effective prosthesis delivers renewed functionality and is cosmetically pleasing, but it also serves to complete the wearer’s sense of wholeness. A prosthesis then, is as much medical device as it is an emotional comfort, and so the history of prosthetics is not only a scientific history, but the story of human beings since the dawn of civilization who by birth, wound, or accident were left with something missing.

Reestablishing Wholeness

The earliest example of a prosthesis ever discovered is not a leg, arm, or even a fake eye, it’s a toe. A big toe, belonging to a noblewoman, was found in Egypt and dated to between 950-710 B.C.E. We all know that toes are important, but it’s interesting that our earliest physical example of the history of prosthetics is a toe and not something that might seem more important, like a leg or an arm. The big toe was particularly important to an Egyptian because it was necessary in order to wear the traditional Egyptian sandals. Worn nearly 3,000 years ago, this toe is a representation of the history of prosthetics being as much about function as identity. The big toe helped complete the woman, but it also completed the Egyptian. It may have been easier and/or cheaper to fashion some other kind of shoe, but we can assume that wearing the traditional thonged sandals of Egypt was important enough to this woman’s identity to warrant the construction of this early prosthesis.

B.C.E.

The most famous Ancient Roman in the history of prosthetics is General Marcus Sergius, who is considered the first documented wearer of a prosthetic limb. In the second Punic War, Sergius lost his right hand and was given a prosthesis, fashioned from iron, that enabled him to hold his shield and continue fighting. His loss of limb happened very early in what would become a long military career (he was later captured by Hannibal twice, and escaped both times).

1500s – 1800s

The history of prosthetics has always been intertwined with the history of warfare and the soldiers that fight. Examples from the middle-ages show how slow the field of prosthetics advanced. Iron hands fashioned for knights are no more advanced than the prosthetic used by General Sergius a thousand years earlier.

In the early sixteenth century, doctor Ambroise Paré made significant advances in both amputation surgery, and the development of prosthetic limbs. He was the first to introduce a hinged prosthetic hand, and a leg with a locking knee joint. These advancements, as well as his innovative techniques of attaching the limbs, are unfortunately still rather common in modern prosthetics.

While there was little progress in the limbs themselves between the 1500s and the 1800s, advancements in amputation surgery developed in the mid 19th century allowed doctors to shape the residual limb in such a way that made them more receptive to the attachment of a prosthesis. The limbs weren’t much better, but life was becoming more comfortable for those wearing them.

Taking Technological Leaps

American Civil War

The carnage of the Civil War led to a dramatic increase in the number of amputees, and the field of prosthetics needed to rise to the demand. James Hanger, a confederate soldier, became the first amputee in the war and went on to invent the ‘Hanger Limb’ a prosthetic leg made from barrel staves and metal, that featured hinged joints at the knee and ankle. The Hanger Limb was the most advanced limb in the history of prosthetics, and the company he founded continues to be a leader in the industry today.

20th Century

In spite of the tremendous loss of life and limb in the World Wars, there wasn’t a corresponding leap in prosthetic technology like the one seen in the Civil War – at least not until 1946, when researchers at UC Berkeley developed a suction sock for lower-limb amputees. Similar attachment technology is still in use today.

In the 1970’s, the inventor Ysidro M. Martinez made a huge impact on the history of prosthetics when he developed a lower-limb prosthesis that, instead of trying to replicate the motion of a natural limb, focused on improving gait and reducing friction. By relieving pressure and making walking more comfortable, Martinez (an amputee himself) improved the lives of many future patients.

Combining Aesthetics, Wholeness and Function

Today and Beyond

Today is an exciting moment in the history of prosthetics. It’s a time when great strides are being simultaneously made on the both the aesthetic and functional fronts thanks to new technologies and the never-before-seen pace of innovation.

Modern materials like carbon fiber are making prosthetics both lighter and stronger. Advancements like 3D printing and biometrics have enhanced the lives of amputees and will continue to do so.

Consider the Barlett Tendon Knee, and the work of Dr. Todd Kuiken and think of their relevance not only to the lives of modern patients, but in the history of prosthetics. Like the Egyptian Noblewoman who needed her toe not only for walking, but to be whole as an Egyptian, modern prosthetics move beyond the demands of basic function and deliver a more complete sense of wholeness to amputees who refuse to be held back from enjoying the same passions, mobility and activities as abled body.

At UNYQ, 3D printing technology is being used to create beautiful protective prosthetic covers that help restore symmetry to amputees’ silhouettes, and inspire confidence. By creating personalized and attractive covers, UNYQ is able to help shift the perception of a prosthesis as a reflection of tragedy to an expression of personality.

UNYQ is not alone. There is a wave of initiatives to harness 3D printing and new materials to create prosthetics for fingers, arms and legs. What’s exciting to see is that the aesthetics are becoming just as important to designers and amputees as the function. We are no longer leaving people with an incomplete sense of self.

To follow the history of prosthetics is to chart a plot through the history of civilization, where the technology, politics, and languages change, but the desire to be complete and to belong never does. Our modern world of rapid technological advancements, connectivity and social media means that the future of prosthetics is full of more than just exciting advancements in medicine, it is also a place where amputees can easily find one another and share stories, advice, and comfort.

If the history of prosthetics is the story of human beings struggling to regain a wholeness they have been tragically denied, than these modern social advancements cannot be ignored. Our limbs are part of what makes us Homo Sapiens, but it’s our shared experiences, connections, and friendships that truly make us human.

Images: