Prosthetics

PROBLEM

There are about 10,000 amputees in Georgia, many of them from land mines laid during the conflict with Abkhazia. These mines still exist and continue to produce victims. A recent sampling of amputees revealed:

The only production now is by the International Committee of the Red Cross, which has three production facilities, one of which is in Abkhazia. About 500 prostheses are produced by hand per year, made of materials, which do not last more than a couple of years. Prostheses and orthotics were never a priority in the former Soviet Union. During the final decade of the Soviet period prostheses were made predominantly of wood, with some use of leather and steel. The devices were heavy, inconvenient and had many problems with the socket. The elderly and young found them almost impossible to use. The average time of exchange for a new one was four years, with many episodes of mending in between.

Current production is far below the need. Waiting lists are years long. The devices produced are made from plastic and foam; the prosthesis is inexpensive and innovative but somewhat limited in function. They do not last more than a few years. Prostheses for different activities--such as athletics--are not attempted. Measurement of the stumps is done in the three facilities. An even greater need exists for orthotic care. Hip and spinal orthoses are produced on rudimentary equipment in inefficient processes, if they are produced at all. Follow-up physical therapy is lacing; physiotherapy is not integrated with prostheses production, a holdover of the former Soviet Union.

ACCOMPLISHMENTS

The prosthetics laboratory of Fitzsimmons Army Hospital (a value of about $200,000) was donated and set up in Tbilisi.

Dr. Mark Geil of Georgia Tech piloted a digitizer for measuring stumps. This is a highly portable device that operates with a laptop computer. It makes the measurements of the stump and puts the data into digital form. Stumps can be measured in any location and the information transmitted electronically to a central facility, where CAD CAM technology can be used to produce approximately thirty prostheses a day, about 7,000 per year, compared with about 300 now. The pilot was highly successful.

A needs survey of the amputee and prosthetics situation in Georgia was carried out. This information was used to prepare a proposal for CAD CAM technology to be applied to the production of prostheses. The combination of CAD CAM technology and digital measurements of stumps will make it possible to carry out the measurements throughout the country, and have the prostheses produced in Tbilisi.

The number of prostheses that can be produced per year with this model will rapidly meet the needs of Georgia. It can easily be extended to Armenia and Azerbaijan.

Research at Georgia Tech is underway to discover cheaper but better materials, and to improve the design of the devices. A lot of progress has been made.

PUBLICATIONS AND PRESENTATIONS

FUTURE PLANS

Prosthetics and Orthotics in Georgia: a Five Year Plan (to be put in pdf)

FUNDING

State of Georgia Board of Regents Office of International Education
US AID
American International Health Alliance

MORE INFORMATION

Mark Geil <mark.geil@hps.gatech.edu>

Robin DeAndrade robin_deandrade@emory.org

Prostheses Design http://www.hps.gatech.edu/geil/gpalms/design.htm

LINKS

Georgia Institute of Technology, Dr. Mark Geil
[ http://www.hps.gatech.edu/geil/gpalms/]

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