Prosthesis - History

History

Prosthetics have been mentioned throughout history. The earliest recorded mention is the warrior queen Vishpala in the Rigveda. The Egyptians were early pioneers of the idea, as shown by the wooden toe found on a body from the New Kingdom. Roman bronze crowns have also been found, but their use could have been more aesthetic than medical.

Another early mention of a prosthetic comes from the Greek historian Herodotus, who tells the story of Hegesistratus, a Greek diviner who cut off his own foot to escape his Spartan captors and replaced it with a wooden one. Pliny the Elder also recorded that a Roman general who had his arm cut off had an iron one made to hold his shield up when he returned to battle. A famous and quite refined historical prosthetic arm was that of Götz von Berlichingen, made at the beginning of the 16th century.

Around the same time, François de la Noue is also reported to have had an iron hand, as is, in the 1600s century, René-Robert Cavalier de la Salle. During the Dark Ages, prosthetics remained quite basic in form. Debilitated knights would be fitted with prosthetics so they could hold up a shield. Only the wealthy could afford anything that would assist in daily life. During the Renaissance, prosthetics developed with the use of iron, steel, copper, and wood. Functional prosthetics began to make an appearance in the 1500s.

Götz von Berlichingen, a German mercenary, developed a pair of iron hands that could be moved by a series of catches and springs. An Italian surgeon recorded the existence of an amputee who had an arm that allowed him to remove his hat, open his purse, and sign his name. Improvement in amputation surgery and prosthetic design came at the hands of Ambroise Paré. Among his inventions was an above-knee device that was a kneeling peg leg and foot prosthesis with a fixed position, adjustable harness, and knee lock control. The functionality of his advancements showed how future prosthetics could develop.

Other major improvements before the modern era:

• Pieter Verduyn - First nonlocking below-knee (BK) prosthesis.
• James Potts - Prosthesis made of a wooden shank and socket, a steel knee joint and an articulated foot that was controlled by catgut tendons from the knee to the ankle. Came to be known as “Anglesey Leg” or “Selpho Leg.”
• Sir James Syme - A new method of ankle amputation that did not involve amputating at the thigh.
• Benjamin Palmer - Improved upon the Selpho leg. Added an anterior spring and concealed tendons to simulate natural-looking movement.
• Dubois Parmlee – Created prosthetic with a suction socket, polycentric knee, and multi-articulated foot.
• Marcel Desoutter & Charles Desoutter – First aluminum prosthesis

At the end of World War II, the NAS (National Academy of Sciences) began to advocate better research and development of prosthetics. Through government funding, a research and development program was developed within the Army, Navy, Air Force, and the Veterans Administration.

The following organizations have been created to help and inform the general publics about prosthetics:

• American Orthotics and Prosthetic Association, American Board for Certification in Prosthetics and Orthotics, American Academy of Orthotics and Prosthetics – These three groups work together to take responsibility for the academic side of orthotics and prosthetics and provide certification of individuals and facilities working with orthotics and prosthetics.
• The International Society for Prosthetics and Orthotics – Founded in 1970 and headquartered in Copenhagen, this association helps with the progression in research and clinical practice worldwide. They hold an international conference every three years and publish their own technical journal.
• Association of Children’s Orthotic-Prosthetic Clinics – The organization was started in 1950s to advocate research and development of children’s prosthetics. They meet annually and have their own publication.
• Amputee Coalition of America – The organization was created in 1990 to improve the lives of amputees. Advocate the improvement of amputee lifestyle through education and also have their own publication, inMotion.