Open source prosthetics

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Clicking into an article by Aimee Mullins, a double below knee amputee, actress, track athlete, and total babe, resulted in a moment of groaning "what the hell" at my computer screen. The article -- "Is Choosing a Prosthesis so Different than Picking a Pair of Glasses?" -- spoke of how prosthetics have evolved to the point of being as specialized and aesthetically unique as eyeglasses in the last fifty years in the United States.

To illustrate her point, Mullins notes:

"...no one has yet to build a leg that does it all --- I have to change legs when I want to wear high heels; I have to change legs when I want to wear different height high heels; I have to change legs when I want to swim, take a boxing class at the gym, or sprint on the track. I have 12 pair in all (though many are housed in museums)."

While the there are indeed parallels, the article largely neglects the enormous burden of cost and limited access to this cutting-edge technology that so often gets featured in the press. Those very legs that Mullins has relegated to museums sit well out of financial reach for the majority of the disabled community.

Full disclosure: I myself am a double amputee; being born without legs. No stumps, femurs, or anything. I start at the pelvis. I never experienced the contrast of pre/post disability. I grew up thinking of myself as whole and complete. Whenever I was confronted with a set of legs, they felt like highly impractical stilts designed with aesthetics over function in mind.

I remember always feeling a mix of awkwardness and obligation when I slid into the big, wobbly, pair of legs. The only element that kept me in prosthetics was the reminder from doctors, family, and therapists of the time and money they took to create.

At every possible opportunity, I would abandon the legs in favor of running on my hands -- or later in life, using a skateboard. I found that the practicality and affordability of these two options allowed for more financial and logistic freedom for getting around the everyday world. If I was traveling and something on my skateboard broke, I could buy a replacement locally (and cheaply). If a glove got torn up on a hike, I could wrap some duct tape around it. My family had always focused on simple and practical solutions to any physical challenges I might face, and eventually I learned how to "MacGyver" my way out of situations as well.

I found out about www.openprosthetics.org in March, and immediately fell in love. NPR described the creator, Jonathan Kuniholm's mission, as an "open-source collaboration that makes its innovations available to anyone."

One of the most interesting examples was the reviving an old upper extremity prostheses that had been originally developed in the 1920s or '30s. Named the Trautman Hook, it consisted some rubber bands, three metal parts, and two screws. All of the designs were posted for free on the site, as well as fabrication costs from different companies around the country. A practical and cost-conscious alternative to the expensive and single function prosthetic paradigm felt like a revelation. Open Source. Some weird, cool concept that only futurists could write about. The Firefox of artificial limbs.

For a bit more perspective on the cost and difficulties of obtaining a prosthesis, I rang up Cliff Creekmore, the manager of a local Hanger Prosthetics branch in Montana.

"As of July of 2008, a moderate activity prosthesis for a below-the-knee amputee costs about $17,500."

For a double amputee, the expense doubles. And getting insurance to cover more than one leg is a hassle. When you put those costs in context of Aimee Mullins quote, from a financial perspective, buying a prosthesis is a world apart from buying glasses.

Thankfully, Aimee does go so far as to admit the issues confronted by the average prosthetic user, "Not one pair of my legs is covered by insurance; not one pair of my legs is considered "medically necessary."

And so, in the face of such debilitating costs and access to the prosthetics, it's incredibly liberating to see movements like The Open Prosthetics Project gaining momentum. Could it ever grow large enough to become an alternative to the private routes? I don't know, but I dearly hope so. As we've seen in many other areas, open source competition tends to breed innovation from incumbents, It would be something to one day finally see prosthetics that are adaptable and multi-use without the steep costs we currently experience.

Check out their main site to see some of the finished projects.

And if you want to get into the nuts-and-bolts of developing projects, head to their Ning site.