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Proposed national artificial limb scheme - indicator of prosthesis cost : Number of hours required for limb manufacture

Table of number of hours required for limb manufacture: code, historical hours and final figures:

Code	Historical hours (descriptions vary according to source)	Final DVA figures
1 A   Below elbow - work prosthesis, moulded socket, hook, cable & harness	16hrs 45mins  *	16
1 B   Below elbow - dress prosthesis (self suspend), moulded socket, cosmetic hand & glove	15.87	15
1 C   Below elbow - dress prosthesis (harness suspend), moulded socket, cosmetic hand & glove, cable& harness	16.87	16
1 F   Partial hand prosthesis, moulded socket, hand and glove	N/A	8
2 A   Above elbow - work prosthesis, moulded socket, elbow unit, hook, cable & harness	22hrs 30mins  *	20
2 C   Above elbow - dress prosthesis, moulded socket, elbow unit, cosmetic hand & glove, cable & harness	20.87	18
3 B   Shoulder disarticulation prosthesis - modular moulded socket, shoulder unit, elbow unit, cosmetic hand & glove, cable & harness. Including soft cover	19.87	20
3 C   Shoulder disarticulation prosthesis - standard, moulded socket, shoulder unit, elbow unit, hook, cable & harness	N/A	36
4 A   Anke, Symes, Moulded socket, Sach foot	21hrs 15mins  *	21
4 C   Partial foot, moulded socket, tibial tubercle height, with toe filler	N/A	21
5 A   Below knee, exoskeletal system, moulded socket, Sach foot	18hrs 30mins  *	21
5 E   Below knee, endoskeletal system, moulded socket, Sach foot, including soft cover and finishing	N/A	21
6 A   Below knee, exoskeletal system, moulded socket, joints and thigh lacer, Sach foot	34.87	33
6 B   Below knee, endoskeletal system, moulded socket, joints and thigh lacer, Sach foot. Including soft cover and finishing	31hrs 15mins  *	31
6 C   Below knee, exoskeletal system, moulded socket, joints and ischial bearing thigh section, Sach foot	37.87	36
6 D   Below knee, endoskeletal system, moulded socket, joints and ischial bearing thigh section, Sach  foot.  Including soft cover and finishing	N/A	34
7 A   Knee disarticulation (or through knee), endoskeletal system, moulded socket, Sach foot, including soft cover and finishing	N/A	35
7 B   Knee disarticulation (or through knee), exoskeletal system, moulded socket (Laminate or leather), external knee joints, shin, Sach foot	N/A	43
8 A   Above knee, exoskeletal system, moulded suction socket, single axis constant friction knee, shin, Sach foot	32hrs  *	35
8 B   Above knee, endoskeletal system, moulded suction socket, Sach foot, single axis knee, including soft cover and finishing	33.87	33
9 A   Above knee, exoskeletal system, moulded socket, single axis constant friction knee, shin, Sach foot, waist band	39hrs  *	35
9 B   Above knee, endoskeletal system, moulded socket, single axis knee, Sach foot, waistband, including soft cover and finishing	36hrs  *	35
10 A  Hip disarticulation, Canadian type, exoskeletal system, moulded socket, hip joint, single axis constant friction knee, shin Sach foot	52hrs  *	48
10 B  Hip disarticulation, Canadian type, endoskeletal system, moulded socket, hip joint, single axis knee, Sach foot, including soft cover and finishing	50.87	46
Repairs (time calculations under construction)

Available details of time for selected limbs (Please note: historical data- actual processes may no longer be relevant)
 

Code & time total
1 A   Below elbow - work prosthesis, moulded socket, hook, cable & harness
16hrs  45mins composed of: Measure and record stump (1) Prepare to take cast (.45) Take cast (1) Fill negative (30) Modify positive (1) Laminate socket (1) Trim and sand (.45) Check fit (.30) Determine length of arm and attach (1.30) Foam or wax wrist unit to socket (1.30) Shape and prepare for lamination (1) Laminate (.45) Trim and finish (1) Manufacture cable (1.30) Manufacture harness/triceps pad (1.30) Adjust harness and cable( .45) Pick up (.45)
2 A   Above elbow - work prosthesis, moulded socket, elbow unit, hook, cable & harness
22 hrs 30 mins composed of: Measure and record stump (1) Prepare to take cast (socks etc) (1) Take cast (1.30) Fill negative cast (.30) Modify positive cast (1.30) Laminate socket (1) Trim and sand socket (.30) Check fit socket (.30) Build up socket. attach turntable, shape (2) Laminate upper arm section (1) Finish upper arm section (1.30) Make plaster forearm mould (.45) Determine length of forearm,attach wrist unit (.45) Lay up and attach elbow hinge (1) Laminate forearm (.45) Sand forearm micro indents and relaminate (1) Attach forearm to upper arm and wrist unit reassemble (1.30) Manufacture cable (1.30) Manufacture harness (1.30) Adjust harness and cable (1) Pick up (.45)
4 A   Ankle, Symes, Moulded socket, Sach foot :
21hrs 30mins composed of: Measure and record stump (.45) Prepare for casting (.15) Cast stump (.45) Fill female cast with plaster of paris (.15) Modify male cast (1.30) Laminate plastic socket and relaminate plastic cover (2.30) Fit  socket to patient, modify opening (3.30) Fit Sach foot to shoe (1) Fit  socket to Sach foot (2) Statically align the leg (.45) Trial walk dynamically align (2.30) Bond Sach foot to socket (1) Prepare for finishing  (1.30) Finishing (leather room) (1.30) L & A finish (1.30)
5 A   Below knee, exoskeletal system, moulded socket, Sach foot :
18hrs 30mins composed of : Record prosthetic information on chart, including supra condular medio lateral dimension  (.45) Select correct wedge and take female cast (.45) Fill female cast with plaster of paris with wedge in position (.30) Modify male cast (1.45) Manufacture distal liners using plastazote (1.15) Manufacture plastic socket (1.30) Remove plaster of paris, set socket into wooden block (1.45) Fit moulded Sach foot to shoe (.30) Assemble components on adjustable leg and align same (1.30) Attach auxilliary suspension (.15) Dynamically align and trial walk patient (2) Duplicate alignment in transfer jig (1) Prepare leg for finish (3) Plasticise limb (1) Assemble and glue foot (1)
6 B   Below knee, endoskeletal system, moulded socket, joints and thigh lacer, Sach foot,  Including soft cover and finishing
31hrs 15mins composed of :	Fit moulded foot to shoe (.30) Record prosthetic information on chart (.45) Prepare wooden block for fitting (.30) First fitting (stump in wooden socket) (.30) Plumb wooden block (.30) Shape in rough (1) Fit side iron (3) Build up to correct height and shape roughly (3) Cut standard leather lacer (.30) Assemble components, fit lacing strips, bend irons (3) Attach studs for auger belt, trial walk (3.30) Prepare leg for finish (3.30) Stainless steel ring (1.30) Plastic room (1.30) Finishing room (5.30)
8 A   Above knee, exoskeletal system, moulded suction socket, single axis constant friction knee, shin, Sach foot
32 hrs composed of : Record prosthetic information and measurement on chart (.45) Take cast of stump, using VAP casting jig (1.30) Fill female cast with plaster of paris (.45) Evaluate and modify cast (3) Lay up and modify socket (1.30) Set plastic socket in wooden block, fit valve (2) Fit Sach foot to shoe (.30) Attach socket and foot to adjustable leg (1) Bench align adjustable leg (.30) Fit leg to patient, dynamic align limb (3) Duplicate alignment in transfer jig (1.30) Rough shape limb (3) Trial walk in rough (1.30) Prepare for finishing (5.30) Finish, plasticise and trim - plastic room (4.30) Finish, fit foot, seal socket - finishing room (1.30)
9 A   Above knee, exoskeletal system, moulded socket, single axis constant friction knee, shin, Sach foot, waist band :
39hrs composed of : Record prosthetic information and measurement on chart (.45) Take cast of stump, using VAP casting jig (1.30) Fill female cast with plaster of paris (.45) Evaluate and modify cast (3) Lay up and laminate socket (1.30) Set plastic socket in wooden block (.45) Fit Sach foot to shoe (.30) Attach socket and foot to adjustable leg and fit pelvic band components (4.30) Bench align adjustable leg (.30) Fit leg to patient, dynamic align limb (3) Duplicate alignment in transfer jig (1.30) Rough shape limb (3) Trial walk in rough (1.15) Prepare for finishing (7) Finish, plasticise and trim - plastic room (4.30) Finish - finishing room (5)
9 B   Above knee, endoskeletal system, moulded socket, single axis knee, Sach foot, waistband, including soft cover and finishing
36 hrs composed of: Record prosthetic information and measurement on chart (.45) Take cast of stump, using VAP casting jig (1.30) Fit female cast with plaster of paris (.45) Evaluate and modify cast (3) Lay up and modify socket (1.30) Set plastic socket in wooden block (.45) Fit Sach foot to shoe (.30) Attach socket and foot to adjustable leg and fit pelvic band components (3) Bench align adjustable leg (.30) Fit leg to patient, dynamic align  limb (3) Duplicate alignment in transfer jig  (1.30) Rough shape limb (3) Trial walk in rough (1.15) Prepare for finishing (6) Finish, plasticise and trim - plastic room (4.30) Finish - finishing room (4.30)
10 A  Hip disarticulation, Canadian type, exoskeletal system, moulded socket, hip joint, single axis constant friction knee, shin Sach foot
52 hrs composed of : Measurements (1) Cast of stump, prefabricate stockingette (4) Prepare check socket (2.30) Walk patient (2) Fill check socke  with plaster of paris (1) Modify positive cast (3) Laminate plastic socket (4.30) Attach hip joint socket set side irons into thigh block (3) Fit Sach foot to shoe, assemble components on adjustable leg (2) Static align prosthesis (1) Walk patient and dynamic align (5) Set up in transfer jig (2) Rough cosmetic shape (3) Trial walk patient (1.30) Prepare for finish (7) Plasticising (4.30) Finishing (5)

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