Life after the earthquake: Providing prosthetics and liners for Turkey’s amputees

As the dust settles in Turkey, a local medical device manufacturer is on an important mission to support amputees through life-changing prosthetics. Here’s how Elkem got involved.

In the early hours of a Monday morning on the 6th of February 2023, a major earthquake registering 7.8 on the official magnitude scale struck south-east Turkey, causing large-scale damage to Gazientep – the city nearest the epicentre. Multiple aftershocks followed, including a 7.5-magnitude quake later the same day.

Turkish hospitals were overwhelmed as the number of injured people pulled from the rubble reached 100,000. According to a United Nations assessment, as many as 70% of injured survivors are expected to have a disability. Amongst the disabilities, many people had to have their injured limbs and extremities amputated in order to avoid fatal ‘crush syndrome’ complications.

These sudden amputations are often life-saving, but they are always life-changing. Months later, many are still figuring out how to get their lives back on track. As the country rebuilds, one aim of the government has been to provide prosthetics to those who lost a limb as a result of the earthquakes, particularly anyone who cannot afford the device at market price.

The power of prosthetics

With the latest advancements in prostheses, artificial limbs have become increasingly better at mimicking the function and sometimes even appearance of a real arm or leg. While the main goal of a prosthetic limb is to restore basic abilities, in many cases these devices have empowered amputees to push themselves to new physical extremes, defying all expectations in the process.

Proted is Turkey’s leading manufacturer of prosthetics and orthotics (O&P). Originally established in 1992 as a rehabilitation centre in Ankara, Proted expanded into R&D and production with an aim to reducing the country’s dependence on imported prostheses. The manufacturer is now an important supplier to all of Turkey’s leading centres for O&P rehabilitation and exports parts and devices from its 2,000-plus product range to more than 63 countries around the world.

From the beginning, Proted’s vision has been to provide the highest quality O&P parts and fitting services needed to increase the general quality-of-life of disabled people. But as the horror of the February earthquakes hit home, Proted’s CEO Murat Sahin decided to go one step further by providing affordable prosthetics to the people in need.

As the company sprang into action producing upper- and lower-limb prostheses for the earthquake victims, a high volume of liners were required alongside the mechanical parts. Liners are intended to fit like a socket around the residual limb. They serve as the interface between the person’s body and the hard, metallic part of their prosthetic, with the purpose of protecting the skin and providing a consistent, comfortable fit.

With liners changed on average once every six months, and hundreds of hospitalised earthquake victims in need, Proted reached out to its long-time silicone supplier, Elkem, for support. Back in 2013, Elkem had been instrumental in helping Proted establish a manufacturing line for liners, and has remained the company’s valued supplier of silicone material ever since.

After a conversation about Proted’s mission to help earthquake victims, Elkem was happy to support the liner production with sufficient material to cover these additional needs, free of charge.

Why silicone?

While liners feature a relatively simple sleeve-like design, much of their performance rests on the right material choice. A medical-grade soft silicone elastomer such as a Room Temperature Vulcanizing (RTV) material provides the right elasticity levels to maintain a tight fit while reducing the pain and discomfort that arise from pressure points.

“Silicones are highly biocompatible and hypoallergenic, so the body tolerates them well,” adds Clement des Courieres, Healthcare Market Manager EMEA at Elkem Silicones. “They also have better durability than other materials that can be considered for liners, meaning patients won’t need to change the liner as frequently compared to other materials.”

Silicone offers additional advantages on the manufacturing side. According to des Courieres, the low viscosity of certain silicones – especially the skin-contact RTV grades amongst Elkem’s Silbione™ range – means the raw material is easy to pour into a mould. The silicone cures into shape quickly and a textile can then be glued on top.

Yet despite these various advantages, des Courieres believes silicone’s popularity amongst prosthetic companies all comes back to the comfort factor. “Silicone is soft and has a cushioning effect on the body. For prosthetic liners, that is the most important aspect,” he says.

Elkem is one of the world’s leading suppliers of medical-grade silicone materials. When the team received the request from Proted in February, it was an easy decision to get involved in the partner’s program to support earthquake victims.

“Elkem is committed to developing, manufacturing and delivering high-quality silicone materials that improve lives. One very important application for our medical-grade technologies is these prosthetic liners for amputees, as this is a situation where the silicone can have a huge impact on a person’s day-to-day comfort and quality of life, including their ability to walk again. We have worked with Proted for around ten years now, right from when they were first expanding their manufacturing to where they are now, and we are proud to support them on their current effort to help improve the lives of the earthquake victims who lost an arm or leg in Turkey” comments des Courieres.

A lot has been lost by the survivors in south-eastern Turkey, including family members, friends, homes, and businesses. Many of these things can never be restored. While the same is true for people who lost a limb during the disaster, advancements in medical technology mean there is still hope for an active, independent, and fulfilling life. By providing complementary artificial limbs and important accessories such as silicone liners to the people who cannot afford the device at market price, Proted and its partners are helping to build back Turkey one prosthetic limb at a time.