Key Concepts

• With enhanced emergency medicine, many soldiers are coming home from war with grievous injuries instead of being killed.
• Innovation in arm and hand prostheses has been slow because the market for the devices is small and development costs are high.
• The Open Prosthetics Project (OPP) has applied the “open source” model—long used in developing “community-based” software—to the design of inexpensive prosthetic hands and arms that a small demand can still support. The designs are free for anyone to use.

Before Jonathan Kuniholm, a marine re­­serv­­ist, was shipped off to the war in Iraq, he and three friends formed a research and development firm they called Tackle Design. The four men had worked together in an industrial engineering class at North Carolina State University (N.C.S.U.), and, filled with youthful enthusiasm, they hoped their fledgling company could survive on jobs that were interesting and beneficial rather than simply moneymaking. They worked with inventors—making prototypes for a plastic lock to keep shoestrings tied and a fishing lure with an embedded LED—as well as with medical engineers from their alma mater, who were developing tools for minimally invasive robotic surgery.

Then, before business had a chance to get off the ground, Kuniholm was deployed. A few months later, on New Year’s Day 2005, he and about 35 other marines were ambushed near the Hadithah Dam along the Euphrates River northwest of Baghdad. His platoon had been looking for insurgents who had fired at a Swift boat patrolling around the dam a few hours earlier. As the marines closed in on the suspected hotspot, an IED—improvised explosive device—hidden in a can of olive oil exploded. Shrapnel ripped through the platoon, and Kuniholm was blasted off his feet. Moments later, when he came to his senses, he discovered his M16 rifle had been blown in half and his right arm was nearly severed just below the elbow. Caught in a raging firefight, Kuniholm pulled himself out of harm’s way. His fellow marines called for air evacuation, and soon surgeons at a hospital near Baghdad were amputating his ravaged arm.

   
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