Acceptability of a Functional-cosmetic Artificial Hand for Young Children. Ii.

The need for a functional and cosmetically-acceptable hand for juvenile amputees has existed for many years, In 1958 the Army Prosthetics Research Laboratory attempted to fill the void by developing a child's voluntaryopening hand, denoted as size No. 1. The Sierra Engineering Company con­ tracted to manufacture this hand, and two other companies (Kingsley M a n u ­ facturing Company and Prosthetic Services of San Francisco) were enlisted to manufacture suitable cosmetic gloves. Following preliminary testing of a prototype model, modifications to eliminate certain shortcomings were incorporated in 50 production models. A field test was initiated in April 1960, with evaluation of the cosmetic gloves included as an integral part of the study. Preliminary findings based upon experiences in fitting 20 children were reported in October 1960 (1). The results indicated that the hand was acceptable cosmetically and provided satisfactory function in the activities typically performed by the children. The general workmanship and cosmesis of the gloves provided by both manufacturers had also achieved a satisfactory level, after certain initial fabrication difficulties. However, several problems had been identi­ fied during this phase of the study, the most serious of which was a lack of glove durability. Ridges and sharp edges on the exterior of the hand ap­ parently contributed to rapid glove damage. It was decided to modify the original production-model hands and then refit them to the subjects in the study. These modifications included the elimination of glove-cutting edges, strengthening of the floating-finger at­ tachments and the spring mechanism of the thumb, and raising the cable exit. In November 1960 "old" hands revised in this manner began arriving at New York University-Child Prosthetic Studies and in April 1961 the manufacturer produced a series of new hands which incorporated all of the above modifications.