When Tamara Westfall lost her right leg below the knee, she became one of about 1.8 million amputees in the United States.
According to Jim Myers, an information specialist for the Amputee Coalition of America in Knoxvile, Tenn., most amputees are older adults who lose limbs because of diabetes and vascular disease.
Westfall, 18, lost her leg because of injuries sustained in a car wreck.
She, like many other amputees, has been able to benefit from advances in technology. Her prosthetic leg allows her to walk with ease and without a limp.
The history of prosthetics goes back to ancient times. According to a report from the Northwestern University Prosthetics-Orthotics Center, people in ancient Egypt, Greece and Rome wore prostheses after the loss of a limb in order to appear whole. In some cultures, death was preferable to the loss of a limb because people feared not having the use of their limbs in the afterlife.
People lost limbs to gangrene, leprosy, injury, congenital deformities and punishment. Those who lost legs walked with the help of crutches or on limbs made of wood and leather, often padded with rags. Over hundreds of years, doctors and others invented prosthetic legs with knees that bent and feet that flexed. Materials used included ivory, platinum and cement.
After the Civil War, the federal government promised to supply prostheses for veterans. Making prostheses became a competitive business. Further advances came after World War I and World War II.
"Every major conflict pushes the technology along," said Tony Saia, an owner of Bio-Tech Prosthetics & Orthotics. "With every war, you have an influx of amputees." Soldiers coming back from Iraq with above-the-knee amputations can get prosthetics with microprocessor knees, he said.
"The knee and the foot talk to each other."
Ten years ago, Saia went to Vietnam to train people who made prosthetic legs. There, he found people walking on prostheses made of tin funnels wrapped with rope or rags.
"Then, they had 250,000 amputees, and they could only make an average of 10,000 legs a year. Half the people there wouldn't wear their new legs home. They put on the tin leg and put (the new leg) under their arm. They knew it was the only one they would ever have."
Bio-Tech made Westfall's temporary prosthesis. Soon, she will receive a permanent prosthesis designed for her age and activity level.
"Usually, in a below-knee (amputation) like hers, what dictates the technology is more the foot," Saia said.
A rubber foot with a wooden core costs a few hundred dollars. A high-tech metal foot, made of a carbon composite and designed for a high level of activity, can cost more than $5,000.
"Walking on a rubber foot is like walking in sand," Saia said. "It compresses under the weight of the body. You get more tired when you're walking in sand." The carbon foot is like a big spring. When a person steps with the foot, it flexes and pushes the person forward.
Westfall will receive a carbon composite foot that flexes front to back and side to side. The flexible foot will allow her to hike over uneven terrain with no trouble.
"The entire foot acts as a shock absorber and a spring," he said. "When she steps on the heel, it will cushion her impact. When she steps on it and pushes, it's like a big spring to propel her forward."
Westfall will be able to do pretty much what she wants to do, including run. Her limitations will be few. She would have trouble, Saia said, swimming laps in a pool.
Function will be the most important purpose of Westfall's prosthesis, he said, but he will make sure the leg looks good, too.
"With someone we know fashion is very important, we pick components to make a nice leg."
Westfall's leg and foot will cost around $9,000.
Women who like to wear high heels can get a prosthetic foot designed for heels. Westfall prefers flat shoes.
In six to 12 months, she will need another prosthesis because the fit will change as the remainder of her leg continues to shrink.
"She'll have a lot of legs in her lifetime," Saia said. People often keep an old leg to mow the lawn in or one to take a shower in.
"They become like old sneakers."
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