Minnesota National Guard Sgt. Darrell "J.R." Salzman has learned to tie delicate trout flies with his mangled left hand and the shiny metal hook that serves as his right called Utah Arm - which the Army gave him.
The myoelectric Utah Arm, made by Motion Control Inc., of Salt Lake City, has circuitry that reads muscle twitches as electric signals to open and close a hook or hand attachment. But its response time, even at less than a second, is so slow that Salzman prefers an old-fashioned, "body-powered" prosthesis, controlled by a cable and rubber bands.
"I don't like having to wait if I want to grab something," Salzman said, deftly opening his hook to remove a fuzzy black fly from a vise. "If I want to grab this woolly bugger here, I don't want to have to wait; I want to just go and grab it."
Taking into account the kind of problems faced by these soldiers the Defense Department has contracted with a group of researchers and prosthetics manufacturers to build a thought-controlled arm at a cost of $30.4 million - part of at least $70 million the Defense Department and the Department of Veterans Affairs have committed since 2001 to develop better artificial limbs.
Many companies have received grants to develop better limbs that can be used not only by the war amputees but also the civilian amputees.
Today's approximately 600 war amputees account for only a tiny fraction of the 1.9 million Americans living with limb loss, leaders of the nation's $900 million prosthetics industry say the government's investment will be seen less on their balance sheets than in the sophistication of newfangled prostheses.
The military and VA, which provides lifelong care for veterans, are buying more prosthetic products and services. For example, the VA said it spent $1.1 million last year on prosthetic devices and services, compared with about $529,000 in 2000.
"The military expenditure on prosthetics is obviously booming, and it represents a more and more significant part of our business, but it is still only a small part of our business," said Ian Fothergill, clinical marketing manager for the North American division of Iceland-based Ossur hf., the world's second-largest prosthetics manufacturer. Ossur said sales of prosthetics grew by 12% worldwide and 17% in North America last year.
Wounded warriors historically have helped push the boundaries of prosthetic technology by demanding ever more functional, durable, comfortable devices. These days, the military aims to restore functionality to the point that some troops have returned to battle something virtually unheard of until now.
Germany's Otto Bock health care, the world's biggest manufacturer of prostheses, also has wartime roots. The company's founder and namesake "was considered a little bit like the Henry Ford of the prosthetic industry" for mass-producing devices for World War I veterans, said Brad Ruhl, vice president of sales at the company's North American headquarters in Minneapolis. The privately held firm now has annual sales of about $500 million, but Ruhl wouldn't reveal detailed financial data.
Bock's C-Leg, a microprocessor-controlled knee joint introduced in the late 1990s, is the standard prosthesis issued to U.S. fighters who have lost a leg above the knee, according to the American Orthotics and Prosthetics Association.
"We no longer have to be content just getting them on their feet; we can do more," said Kirk, of Bethesda-based Hanger.