The I.N.A.I.L. experience fitting upper-limb dysmelia patients with myoelectric control.

In the early 1960 's, because of widespread use of thalidomide, a sedative taken by women in early pregnancy, a large number of children were born with severe congenital anomolies, notably dysmelia . These children, now approaching early adulthood, require the application of acceptable functional cosmetic prostheses to serve both their personal needs and to enable them to enter into the social and occupational environment of the community. Until recent years, for the very severe forms of dysmelia, the only means of prosthetic treatment has been with pneumatically powered prostheses (Fig . 1) . Regrettably, our surveys indicate that a very high percentage of children have rejected this type of upperlimb prosthesis . The parents may be a major factor in this rejection because, in performing the activities of daily living for these children, they have diminished the children 's desire to help themselves and to be independent . Another reason often cited is the complexity of the prosthesis itself and the difficulty of securing fresh supplies of energy . Special equipment is required for refilling the gas cylinders (Fig . 2) and this restricts the distances wearers can travel from home unless they carry the necessary cumbersome equipment with them. There are also limitations from the standpoint of function, limitations which do not actively permit all desired movements. (For example : at the elbow, flexion is active and extension is by gravity ; at the wrist, supination is active while pronation is by a spring; and at the shoulder, flexion and extension are passive motions with a pneumatic lock .) These disadvantages naturally diminish considerably the desirability of using pneumatic power for dysmelics .