Prosthetics involves the development of artificial body parts to replace or support existing structures. Prosthetic appliances range from tiny devices such as artificial heart valves, voice boxes and false teeth, to larger artificial joints and limbs.
Orthotic appliances provide external aid and support to persons with mobility problems caused by illness, accidents, polio, cerebral palsy and paralysis. They include calipers, crutches, body braces, surgical shoes, etc, custom-made to fit a person’s requirements.
The fitting of both prosthetic and orthotic devices is a highly skilled task, demanding precision accuracy and attention to detail. Some of them can only be implanted by a surgeon (heart valves, for example) while others are the responsibility of a prosthetic technologist or an orthotist. Fitting anything artificial to the human body makes one even more appreciative of the perfection of the original design. Nothing works quite as well as nature.
However, recent developments in super-light plastics and other “wonder materials” have taken these adaptive appliances light years ahead of what people had to make do with only decades ago.
Both fields require a science background, material and design skills, knowledge about the disability and the ability to work as part of a team with the physician and the physio- and occupational therapist. Having these qualifications, however, will only make a person a competent technician.
A good orthotist/prosthetist goes beyond technical expertise and the “Mr. Fix-It” role to an understanding of the human being in need of his services. A person who comes to him may be particularly vulnerable emotionally. The part of his body he feels most sensitive and protective about is to be subjected to thorough examination and scrutiny, to be poked and prodded, turned this way and that, held up to the light and perhaps even shown to others for their opinion. While it is true that examination is essential, the orthotist/prosthetist recognizes the difficulty of the situation for the person and does his best to make it as easy as possible. Establishing a friendly, trusting relationship before beginning is very important, particularly with a child or a person with a mental handicap. Explaining things as he goes along is also crucial: sometimes just knowing why a thing must be done can make it bearable.
Such a relationship also makes it possible for the person to tell the orthotist/prosthetist when there is a problem with the device. If he is intimidated or overwhelmed, he may not feel able to say if the caliper is too tight or the joint not mobile enough, information which is essential if the device is to be effective.
Finally, it is because of the sensitivity of certain members of the profession that attention is now given to such a seemingly unimportant thing as fashion. Somewhere along the line, a good orthotician realized that a teenager who has to wear an artificial foot has enough problems without having to drag an ugly black shoe around when all her friends are wearing pretty sandals or trendy sneakers. Nowadays, adaptive devices are made as unobtrusively as possible, because people with handicaps don’t just want to be able to move, they also want to dance.
As this particular area in Special Needs is still in its infancy in India, many people are not even aware of the profession. There is, however, a growing demand for these services, and the paucity of technologists is particularly conspicuous in smaller towns and cities. As awareness of the possibilities for a close-to-normal life increases, job opportunities in the profession will also multiply. Because the positive impact of orthotics and prosthetics is so dramatic and immediate, this is a particularly satisfying speciality.