Age of Fitting Upper-Extremity Prostheses in Children

A Clinic Study

¹ Area Amputee Clinic (Michigan Crippled Children Commission), Mary Free Bed Children's Hospital and Orthopaedic Center, Grand Rapids

1. Prosthetic tolerance can be obtained in children as young as five months.

2. Functional patterns involving both hands at a normal distance from the body can be obtained and are facilitated with early upper-extremity limb-fitting.

3. In the very young (under twelve months), any type of passive terminal device can be used. In this series, the plastic mitten type seemed to best fulfill the requirements.

4. Parental acceptance of early fitting has been excellent.

5. Motor skills cannot be developed beyond the individual's level of motor maturation. Early fitting of a prosthesis does not speed up this physiological maturation process.

6. Purposeful grasp and release utilization of an active terminal device can seldom be developed under twenty-four months of age, and is usually not well developed until thirty months of age.

7. Psychic influence of early prosthetic fitting cannot be evaluated at this time.

8. Masking of the sensory function of the amputated or deformed extremity cannot be evaluated at this time.

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