polypropylene technology...at that time, orthopaedic components were made by recycling material left...
TRANSCRIPT
PolyProPylene TechnologyPhysical Rehabilitation Programme
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PolyProPylene Technology
MISSION
The International Committee of the Red Cross (ICRC) is an impartial, neutral and independent organization whose exclusively humanitarian mission is to protect the lives and dignity of victims of war and internal violence and to provide them with assistance. It directs and coordinates the international relief activities conducted by the Movement in situations of conflict. It also endeavours to prevent suffering by promoting and strengthening humanitarian law and universal humanitarian principles. Established in 1863, the ICRC is at the origin of the International Red Cross and Red Crescent Movement.
International Committee of the Red Cross19 Avenue de la Paix1202 Geneva, SwitzerlandT + 41 22 734 60 01 F + 41 22 733 20 57E-mail: [email protected]© ICRC, June 2007Cover photograph and inside photographs (unless specified): ICRC/PRP
Introduction 2
TheICRC’spolypropylenetechnology:Abriefhistory 4
TheICRC’spolypropylenesystem 6
Internationalrecognition 8
Trainingresources 9
Aconstantlyevolvingtechnology 10
Aboutpolypropylene 11
introductionAs part of its mandate, theICRCplaysanactiveroleinthephysicalrehabilitationofvictimsof conflict and violence. Since1979,theICRChasdiversifieditsactivitiesthroughouttheworld.Theworkofprovidingphysicalrehabilitation for people withdisabilities, as one aspect ofhumanitarian assistance, wasonce confined to emergencyresponse.The ICRC has gonewell beyond that now, inrecognitionofthefactthattheneedforphysicalrehabilitationwillpersistthroughoutthelivesofthedisabled.
TheICRChascometooccupyaleading position in the field ofphysicalrehabilitation,mainlyonaccountoftheworldwidescopeofitsactivities,thetechnologyithasdeveloped,itsexpertiseandits long-term commitment totheprojectsitsupports.Inmostcountries where the ICRC has
2
provided support for physicalrehabilitation, such serviceswere either non-existent orminimal. In most cases, theICRC’s support became thebasisforestablishinganationalreintegrationservice.
The ultimate objective of theICRC’s efforts in this area isto make possible the socio-economic rehabilitation of thephysicallydisabled,duringandafter the period in which theyreceive assistance from theICRC. Providing adequate careandcomfortableprostheticandorthoticfittingforthepatientisanimportantfirststep.ThemainaimsoftheICRC’ssupportare:• tomakerehabilitationservices
accessible;• toimprovethequalityofsuch
services;• toensurethattheseservices
continueinthelongrun.
The role of appropr iatetechnology1 – one that is bothinexpensiveandofhighquality–iscrucial.Suchtechnologymakesrehabilitation services moreaffordableandthusmorewidelyaccessible.Italsomakespossiblethe production of orthopaedicdevicesthataredurableandthatconformtosoundbiomechanicalprinciples.Low-costtechnologyalso minimizes the operatingexpenses of rehabilitationcentresandmakesthelong-termsurvival of such centres morelikely.
TheICRCPhysicalRehabilitationUnitwasestablishedin1979,markingthestartofalong-termcommitment.
1 Appropriate technology: “A system providing proper fit and alignment based on sound biomechanical principles [that] suit the needs of the individual and can be sustained by the country at the most economical and affordable price.” N. Jacobs (ed.) Report of ISPO Consensus Conference on Appropriate Orthopaedic Technology for Developing Countries, ISPO, Phnom Penh, 1995, p.8.
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Inthebeginning,theICRCreliedonimportedmaterialstomanufactureorthopaedicdevicesindevelopingcountries.
It became obvious quickly that while it was possible to produceorthopaedic devices of high quality with such materials, it was alsoprohibitivelyexpensiveandoftenoflimitedusefulness.
Becauseimportingorthopaediccomponentswassimplytooexpensive,the ICRC began to develop and produce them on its own. At first,theICRCusedlocallyavailablematerials;thischangedin1991whenthermoplasticsbecametheICRC’srawmaterialofchoice.Theadvantagesofusingpolypropylenesoonbecameobvious.
WhilethefirstpolypropylenekneejointwasproducedinCambodiain1991,variousalignmentsystemsweredevelopedinColombia inthesameperiodand,gradually,improvementsweremadetothem.In1993,theICRCproduceditsfirstcomponentsmadeofpolypropylene.
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the icrc’s polypropylene technology: A brief history
Atthattime,orthopaediccomponentsweremadebyrecyclingmaterialleftoverfromtheproductionofsockets.
Today,inmostcountrieswheretheICRC’spolypropylenetechnologyisinuse,suchwastematerialisrecycledtomakecomponentsforwalkingaids.
The ICRC’s polypropylene technology has gradually developed sinceits beginnings. Components for all kinds of lower and upper limbprosthesesarenowavailable.
TheICRCchosepolypropyleneforanumberofreasons:• itisrelativelycheap;• ithasalongshelflife(itislong-lastingandcanbestoredeasily);• itrequiresveryfewothermaterialsinthemanufacturingprocess;• itiseasytoprocessandversatile;• itisrecyclable.
TheICRC’spolypropylenetechnologyhasbeendevelopedtomanufactureprostheticdeviceswiththefollowingconsiderationsinmind:• Thedevices/componentshavetobedurable,comfortable,andeasy
forpatientstouseandtomaintain;• Thetechnologyhastobesimpleandeasytoputintopractice;• Thedevices/componentshavetobecompatiblewiththeclimatein
differentregionsoftheworld;• The technology has to be inexpensive and consistent with
internationallyacceptedstandards;• Thetechnologyhastobeflexibleenoughtoaccommodatetheneeds
ofeveryindividual.
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the icrc’s polypropylene technology: A brief history
Connector,
Concave cylinder for
knee-joint small and
feet size between 22
to 28 cm with M10
bolt
Knee-disarticulation setup
Page 24 50
Hip-disarticulation setup
Page 26 50
Trans-Femoral prosthesis setup
Short stump
Very short stump
Connector, Concavecylinder for knee-joint
small and feet sizebetween 22 to 28 cm
with M10 bolt
Page 20 50
the icrc’s polypropylene system
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The design of the componentspermitsprostheticfittingateverylevelofamputationforthelowerandtheupperlimbs.
EVA sheet
soft socket
Trans-Tibial prosthesis setup
cotton
stockinette
long stump
very long stump
Page 22 50
description & setup
Working roundring tool
Rubberwasher
Stainlesssteel spring
(4) Pan headframing screw
Cup elbow,M6 T-nut
Rubber joint
Elbow shell
Washer
Screw M5
Foream
PP wrist unit,M10 T -nut
Hook
Lockinglever
Socket
Page 24 50
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polypropylene provides the core for the prosthetic system developed by the icrc. the injection process is used for making the components.
the other parts of the assistive devices (sockets, cosmetic covers, etc) are made out of polypropylene sheets using thermoforming.
In 2004, the ICRC was awarded the Brian Blatchford Prize by theInternationalSocietyforProstheticsandOrthotics(ISPO).Thiswasinrecognition of the ICRC’s role in making rehabilitation devices morereadily available by developing and propagating low-cost, high-quality polypropylene technology.This technology has become astandardinprostheticsandisbeingusedbyanincreasingnumberoforganizations.
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ThEBRIAnBLATChFORDPRIzE
“...inrecognitionofitsinnovativeachievements,particularlyinthedesignanddevelopmentofthe
polypropyleneprostheticsystem,whichovertheyearshasbecome
astandardforappropriateandlowcostprostheticservicesin
developingcountries.”
internAtionAl recognition
The ICRC has developed short training courses and manuals ofmanufacturingguidelinestointroduceprofessionalstotheuseof itspolypropylenetechnology.
Inaddition,theICRCSpecialFundfortheDisabledhashelpedaccreditedschools – those classified by theISPOas“CategoryII”–toincorporatepolypropylene technology intotheircurricula.
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1. LOWER LIMB PROsthEtIcsPhysical Rehabilitation Programme
PROSTHETICS & ORTHOTICS MANUFACTURING GUIDELINES
Using polypropylene technology
2. UPPER LIMB PROSTHETICSPhysical Rehabilitation Programme
PROSTHETICS & ORTHOTICS MANUFACTURING GUIDELINES
Using polypropylene technology
3. LOWER LIMB ORTHOTICSPhysical Rehabilitation Programme
PROSTHETICS & ORTHOTICS MANUFACTURING GUIDELINES
Using polypropylene technology
trAining resources
Every year, ICRC-supported physical rehabilitation centres use theorganization’spolypropylenetechnologytoproducetensofthousandsof orthopaedic appliances throughout the world. A large number ofnon-governmentalorganizationshavealsoadoptedthistechnology.
Overtheyears,severaltestreportspublishedbytheISPOhaveendorsedtheICRC’spolypropylenetechnologyforuseindevelopingcountries.2
TheICRCconstantlymonitorstheperformanceofitsvariousorthopaedicproductstoensuretheirhighquality.
TheICRC’seffortstowidentherangeofitsproductsthroughresearchconductedtogetherwithitssupplier3andtoimproveitspolypropylenetechnology are unceasing. As a result, these devices have benefitedrecently:kneeandhipdisarticulationprostheticjointsandprostheticfeetforlongtrans-tibialstumps.
2 “The [polypropylene] prosthetic technology [...] is an attractive and durable solution for trans-tibial amputees, which can be recommended, “ISPO report Field test on Trans. tibial prostheses (Heim & Jensen, 2000) page 54. “The ICRC polypropylene system do live to clinical acceptable standards” – ICRC polypropylene technology for Trans-femoral amputees (Raab & Jensen 2004) ISPO 11th world congress report 2004.
3CREquipements SA. Coppet, Switzerland (www.Crequipements.ch).
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A constAntly evolving technology About polypropylene technology
Polypropylenewasdiscoveredintheearly1950sbyanItalianchemist,Giulionatta(1903–1979).hewasawardedthenobelPrizeforChemistryin1963.
In1957,polypropylenewasproducedindustriallybytheItalianchemicalcompany,Montecatini.Itsoverproductionanditslowcostresultedinmanycommercialusesbeingfoundforthenewmaterial. Inmodernscience, inventions often occur in different places simultaneously.Polypropylene is an extreme instance of this phenomenon: it wasindependently invented about nine times. It is a near sibling to oneofitspredecessors,polyethylene.Likepolyethylene,polypropyleneisinexpensive,butitismuchmorerugged.Itisathermoplasticpolymerwith many applications – from plastic bottles to carpets to plasticfurniture–andisveryheavilyusedinautomobiles.
Twotypesofpolypropyleneareusedinprostheticsandorthotics:
Co-polymer(morethan5%polyethyleneisusedinthepolymerizationprocess);Homopolymer(lessthan5%ofpolyethyleneisusedinthepolymerizationprocess).
Polypropylenecan’tbedissolvedandisdifficulttoglue.ItisUV-sensitivebutcertainadditivescanmakeitmoreresistant.Itbecomesmorebrittleatlowtemperatures.
Polypropylenecanbemadelessbrittleandmoreflexiblebymeansofco-polymerizationwithpolyethylene.
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A constAntly evolving technology About polypropylene technology
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public Ations And films
MoreICRCpublications,technicalresourcesandfilmsareavailableon www.icrc.org
Physical Rehabilitation ProgrammeTRANS-FEMORAL PROSTHESIS
MANUFACTURING GUIDELINES
MISSION
The International Committee of the Red Cross (ICRC) is an impartial, neutral and independent organization whose exclusively humanitarian mission is to protect the lives and dignity of victims of war and internal violence and to provide them with assistance. It directs and coordinates the international relief activities conducted by the Movement in situations of conflict. It also endeavours to prevent suffering by promoting and strengthening humanitarian law and universal humanitarian principles. Established in 1863, the ICRC is at the origin of the International Red Cross and Red Crescent Movement.
International Committee of the Red Cross19 Avenue de la Paix1202 Geneva, SwitzerlandT + 41 22 734 60 01 F + 41 22 733 20 57E-mail: [email protected]© ICRC, June 2007Cover photograph and inside photographs (unless specified): ICRC/PRP
PolyProPylene TechnologyPhysical Rehabilitation Programme
0913
/002
0
6/20
07
500
PolyProPylene Technology