ULP Componentry

Terminal Devices (TDs) are

typically shaped as hands, hooks, or for activity specific tasks

Hooks are

functional, not cosmetic, and allow for high precision and great sightlines

Hands look

more cosmetic, but can be hard to open and have poor sightlines

Two designs of Hooks are

1. lyre

2. canted

Lyre means

• parallel

• better for cylindrical objects

Canted means

• not parallel

• precision movements are better with canted hooks

Activity specific TD’s

• helpful for achieving particular task

• may or may not have active prehension

• may not be versatile, beyond designated task

Voluntary Opening (VO)

• resting state is closed

• activated by user to open TD

• grip force is proportionate to springs or rubber bands

Voluntary Closing (VC)

• resting state is open

• activated by user to close TD

• grip force depends on the user’s input, and must be sustained to maintain close

  • unless a backlock is used

Passive TDs

• cosmetically appealing for some

• provide opposition and stabilizing force/surface

#5 Adult Hook

• stainless steel

• serrated surface

• canted fingers

• 4 7/8” long

• 8 oz

What is a consideration when prescribing a #5 adult hook?

there are no grips on this hook and it may scratch surfaces

#5X Adult Hook

• stainless steel

• nitrile rubber lined

• canted fingers

• 4 7/8” long

• 7.5 oz

#5XA Adult Hook

• aluminum alloy

• nitrile rubber lined

• canted fingers

• 4 7/8” long

• 4 oz

#555 Adult Hook

• aluminum alloy

• nitrile rubber lined

• lyre shaped fingers

• 5 1/4” long

• 4.5 oz

#555-SS Adult Hook

• stainless steel

• nitrile rubber lined

• lyre shaped fingers

• 5 1/4” long

• 8.5 oz

#7 Work Hook

• stainless steel

• serrated surface

• knife holder, nail holder

• screw driver holder

• 4 7/8” long

• 10.5 oz

• opening for standard size broom or shovel handles

#7LO Work Hook

• large finger opening

• #7 features

• stainless steel

• serrated surface

• 5” long

• 11 oz

• opening for larger broom or shovel handles

#6 Work Hook

• back lock feature

• #7 features

• stainless steel

• serrated surface

• 5 1/2'“ long

• 14 oz

#3 Work Hook

• shorter #7

• no chisel holder

• stainless steel

• 4 5/8” long

• 10 oz

#8 Medium Adult Hooks

• smaller 5

• canted fingers

• stainless steel

• serrated surface

• 4 5/8” long

• 8 oz

#8X Medium Adult Hooks

• smaller 5X

• stainless steel

• nitrile rubber lining

• lyre fingers

• 4 5/8” long

• 7.5 oz

#88X Medium Adult Hook

• lighter 8X

• aluminum alloy

• nitrile rubber lined

• 4 5/8” long

• 4 oz

#99X Small Adult Hook

• adolescents

• aluminum alloy

• nitrile rubber lined

• 3 7/8” long

• 3 oz

99P Small Adult Hook

• adolescents

• plastisol coating

• canted fingers

• aluminum alloy

• 3 7/8” long

• 3.5 oz

• varied skin tones

#10X Child Hook

• children

• aluminum alloy

• canted fingers

• nitrile rubber lined

• 3 3/8” long

• 3 oz

10P Child Hook

• Plastisol coating

• canted fingers

• aluminum alloy

• 3.4” long

• 3 oz

• “skin tone” colors

12P Infant Hook

• plastisol coating

• stainless steel

• canted fingers

• 2 3/4”

• 3 oz

VC Grip Prehensor

Grip prehensor versions are made with various combinations of steel, aluminum, titanium, and polyurethane gripping surfaces.

• VC can be used with sure lok

• made by TRS

Sure-Lok

• housing split, and toggle pushes against internal cable

• works with VO or VC prosthesis in line with cable system

• VO users can lock their cable to avoid damaging fragile objects (i.e. holding fragile plastic cups)

• VC, Grip Prehensor users no longer have to maintain cable tension to hold and carry objects

Vari-Grip Prehensor and Retro Classic Hook

• designed to be rugged, but lightweight, VO TDs

• Made by Toughware prosthetics

APRL Voluntary Closing Hook

• replaceable lyre fingers

• nitrile rubber lined

• “thumb” posterior

• 6 3/8” long

• 8.6 oz

• 2 opening positions from small switch on case

• locking with cable

Sierra 2 Load Hook

• VO, 2 pinch loads

• 3.5 lbs or 7 lbs

• replaceable lyre fingers

• nitrile rubber lined

• 5” long

• 12.5 oz

C.A.P.P. Terminal Device

• left and right

• spring loaded VO

  • 3 spring tensions

• replaceable thumb

• no need for glove

Driving Ring

• steering wheel spinner ring

• used on automobile steering wheels, boat tillers, aircraft controls, and most bicycles

Dorrance Hand

• S, M, L

• VO of thumb and index and middle fingers

• adjustable pinch force

• breakaway release protects wearer if excessive force is applied

• heavy duty construction

APRL VC Hand

• VC

• movable thumb, index and middle finger

• 2 thumb positions

• backlock feature

• HD

Sierra VO Hand

• HD VO

• backlock feature

  • operates in all finger positions

• 2 thumb positions for varied grips

• similar to APRL hand

Becker Imperial Hand

• round wire fingers allow compliant/adaptive grasp

  • irregular objects

• HD, VO, all fingers move

• hand grip force adjustable with screwdriver

• can be used with a glove

Soft Voluntary Opening (SVO) Hand

• adjustable prehension from 2-6 lbs

• lightweight, rugged construction

• no maintenance required

• low cost

• used with glove

• SVC version has lockable positioning and release with cable pull

Quick Disconnect/Change Wrist

• push button for TD release

• position TD in supination/pronation

• TD is threaded into insert component

WD Quick Change Wrist

• quick disconnect of the TD or sup/pro position

  • wrist face is rotated in one direction to allow removal of terminal device

  • rotating in opposite direction puts TD in free rotation

  • central position of wrist face locks position of TD

Constant Friction Wrist

• consistent friction throughout ROM

• Adjustable friction, with set screw

• nylon insert

• insert replaceable

• various sizes, for adults and pediatrics

Oval Constant Friction Wrist

• not for hands

• longer residual limb lengths (WD)

• adult and medium small size

• adjustable friction, with set screw

Capp Delrin Wrist

• friction collar, adjust with set screw

• 3 sizes

• lightweight

• high level prostheses

  • helpful to have distal light weight components

Endoskeletal Wrists

• lightweight

• passive and adjustable/modular

• cosmetic, with foam and skin cover

Friction Disconnect Wrist

• constant friction

• quick disconnect

• friction positioning

• free positioning

Economy Wrist

• Al, SS, Ti

• simple, low maintenance

• compressing washer provides variable friction when TD is rotated

• heavy duty (with lamination struts)

Sierra Wrist Flexion Unit

• 0, 25, or 50 degree positions

• need base wrist

• recommended for patients with bilateral amputations

  • easier to get to midline for tasks

• push button

APRL Child Flexion Unit

• 0 and 36 degree positions

• constant friction

Flexion-Friction Wrist

• 0, 30, and 50 degree positions

• push lever

• only 1 plane

• adjustable friction

• automatic locking

• not for hands

OB Movo Wrist

• provides flexion/extension of TD at 45, 30, 15, 0, and -15 degrees

• 20 rotation setting in increments of 18 degrees

• quick disconnect for hands, hooks, or working tools

• independent activation of flexion/extension and rotation

TAD 5 Function Wrist

• flexion

• extension

• supination

• pronation

• TD quick disconnect

Ottobock Ratchet Wrist

• lock lever secures and releases pronation/supination position

• ratchet style resistance to pronation/supination when not in the locked position

• a second lever provides quick disconnection of terminal device

Single Axis

• small, regular, large

• heavy duty use

• eliminates pro and sup

Flexible Hinges

• metal or dacron

• metal for heavy duty

• allows pro-sup

Outside Locking Hinges

• elbow disarticulation, when leveling elbow center and distal components won’t fit

• 7 positions; 5 heavy duty

• small, medium, large

Polycentric Hinges

• help manage cubital bunching

• small, medium, adult

Residual Limb Activated Hinges

• very short transradial limb lengths

• limb locks elbow (extension)

• split housing cable

• split socket

• 5 positions

Step-Up Hinges

• geared, sliding

• for pts with bilateral, short transradial amputations

• split socket

• increase range of motion

• increases force requirements needed to operate

Flail Arm Hinges

• locking and spring loaded

• locking medial side

• spring lateral side

• brachial plexus injury