The prosthetic fitting process

November 20, 2009 by Alan Siegel

Prosthetist Luke Richards' small office is tucked deep inside the Jamaica Plain branch of the VA Boston Healthcare System. One morning this spring, a patient's carbon fiber leg rests by his desk. A chrome briefcase, with a picture of Greg Reynolds' new arm on it, sits on the window sill.

Here, in the E Wing of the hospital, veterans are fitted for prosthetic devices. It doesn't end with arms, legs, hands and feet, either. For example, Reynolds is itching to get back to regularly riding his ATV. So Richards suggested a sleeve that will fill out Reynolds' shirt while he's riding.

For Richards, the question is always the same.

"What do we need to do," he says, "to get [the patient] doing what he used to do?"

First, last winter, Reynolds had to get fitted for a prosthetic arm. The process has become sophisticated. In the past, a plaster cast might've been made to determine the size and shape of his damaged torso. The prosthetic fitting, however, now relies on cutting-edge computer-aided design and computer-aided manufacturing software made by OMEGA Tracer.

First, a handheld scanner captured a digital version of Reynolds' upper body. That, in turn, was sent to an OMEGA Carver in the VA's prosthetic workshop.

On a recent visit, Richards fires up the system, which carves patients' residual limbs out of yellow foam blocks. Moments after queuing up an example on the 15-inch screen, the machine goes to work. A few minutes later, Richards pulls out a freshly carved foam leg. (The foam limb is used to create a plastic test socket. If that fits properly, it's laminated and ready for use.)

On a table nearby, a foam torso stands out among foam limbs. A line, in black marker, cuts an imaginary chunk out of its shoulder. It's obvious who Richards is looking at.

"That's Greg," he says.

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