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Prosthetics and orthotics: area of practice

Prosthetists supply and maintain artificial limbs, while orthotists supply aids such as braces, callipers or splints for people needing physical support or protection.

Prosthetists supply and maintain artificial limbs for people who were either born without or have lost a limb. An artificial limb is known as a prosthesis. Patients are usually referred by other healthcare professionals and the aim of treatment is to facilitate everyday life. The first step will be to assess the patient, discuss with them what prostheses are like and run through procedures.

When the patient is ready the prosthetist will prescribe a prosthesis that is appropriate to their needs, take a cast of the residual limb and take any measurements required. The prosthetist will then adjust the cast, before technicians make the artificial limb in the workshop. The limb is then fitted to the patient and adjusted to make sure it works in the best possible way before it is finished off by the technicians so the patient can take it home.

Orthotists provide a range of aids to protect or assist the function of a part of the body. An aid of this kind is known as an orthosis. The work is incredibly varied due to the range of different illnesses, injuries and congenital problems that patients may have. An orthotist will assess a person’s needs and work to facilitate everyday life.

For example, this could be through the provision of protective footwear for a person with diabetes who has lost some of the sensation in their feet, or it could be working with a polio sufferer who needs an orthosis that goes right up the leg to the hip to support their movement.

Most prosthetists and orthotists work in rehabilitation centres, hospitals or clinics, often in close consultation with other members of the healthcare team such as physiotherapists, doctors, nurses and occupational therapists. Working hours can vary depending on the place of work.

Skills required

Prosthetists and orthotists need to be practical, enjoy working with their hands and be able to relate well to people. They should also be excellent communicators as they will deal with a wide variety of people during the day who will each have a different level of understanding – it’s important that they can adapt their language to suit these different audiences. Prosthetists and orthotists will also need to be problem solvers as things may not always follow recognised textbook routes.

Starting out

‘Prosthetist’ and ‘orthotist’ are both protected terms, which means that you have to register with the Health and Care Professions Council (HCPC) before you can begin to practise. You need to study for a HCPC-approved four-year BSc degree in prosthetics and orthotics to be eligible to register. You may also join the relevant professional association, the British Association of Prosthetists and Orthotists (BAPO).

There are some opportunities to work directly for the NHS but most prosthetic and orthotic practitioners are contracted by the NHS to provide a service. They increasingly work as part of multidisciplinary teams. For example, prosthetists may work closely with physiotherapists and occupational therapists as part of amputee rehabilitation teams, and military personnel typically form an increasing part of their caseloads.