# Introduction
The ICRC's polypropylene technology: A brief history The ICRC's polypropylene system

# International recognition
Training resources A constantly evolving technology About polypropylene

# INTRODUCTION
As part of its mandate, the ICRC plays an active role in the physical rehabilitation of victims of conflict and violence. Since 1979, the ICRC has diversified its activities throughout the world. The work of providing physical rehabilitation for people with disabilities, as one aspect of humanitarian assistance, was once confined to emergency response. The ICRC has gone well beyond that now, in recognition of the fact that the need for physical rehabilitation will persist throughout the lives of the disabled.
The ICRC has come to occupy a leading position in the field of physical rehabilitation, mainly on account of the worldwide scope of its activities, the technology it has developed, its expertise and its long-term commitment to the projects it supports. In most countries where the ICRC has 2 provided support for physical rehabilitation, such services were either non-existent or minimal. In most cases, the ICRC's support became the basis for establishing a national reintegration service.
The ultimate objective of the ICRC's efforts in this area is to make possible the socioeconomic rehabilitation of the physically disabled, during and after the period in which they receive assistance from the ICRC. Providing adequate care and comfortable prosthetic and orthotic fitting for the patient is an important first step. The main aims of the ICRC's support are: accessible; services; continue in the long run.
The role of appropriate technology 1 -one that is both inexpensive and of high qualityis crucial. Such technology makes rehabilitation services more affordable and thus more widely accessible. It also makes possible the production of orthopaedic devices that are durable and that conform to sound biomechanical principles. Low-cost technology also minimizes the operating expenses of rehabilitation centres and makes the long-term survival of such centres more likely.
The ICRC Physical Rehabilitation Unit was established in 1979, marking the start of a long-term commitment.
1 Appropriate technology: "A system providing proper fit and alignment based on sound biomechanical principles  suit the needs of the individual and can be sustained by the country at the most economical and affordable price." N. Jacobs (ed.) Report of ISPO Consensus Conference on Appropriate Orthopaedic Technology for Developing Countries, ISPO, Phnom Penh, 1995, p.8.
In the beginning, the ICRC relied on imported materials to manufacture orthopaedic devices in developing countries.
It became obvious quickly that while it was possible to produce orthopaedic devices of high quality with such materials, it was also prohibitively expensive and often of limited usefulness.
Because importing orthopaedic components was simply too expensive, the ICRC began to develop and produce them on its own. At first, the ICRC used locally available materials; this changed in 1991 when thermoplastics became the ICRC's raw material of choice. The advantages of using polypropylene soon became obvious.
While the first polypropylene knee joint was produced in Cambodia in 1991, various alignment systems were developed in Colombia in the same period and, gradually, improvements were made to them. In 1993, the ICRC produced its first components made of polypropylene.

# THE ICRC'S POLYPROPYLENE
At that time, orthopaedic components were made by recycling material left over from the production of sockets.
Today, in most countries where the ICRC's polypropylene technology is in use, such waste material is recycled to make components for walking aids.
The ICRC's polypropylene technology has gradually developed since its beginnings. Components for all kinds of lower and upper limb prostheses are now available.
The ICRC chose polypropylene for a number of reasons:
The ICRC's polypropylene technology has been developed to manufacture prosthetic devices with the following considerations in mind:  Polypropylene provides the core for the prosthetic system developed by the ICRC. The injection process is used for making the components.
The other parts of the assistive devices (sockets, cosmetic covers, etc) are made out of polypropylene sheets using thermoforming. 

# INTERNATIONAL RECOGNITION
The ICRC has developed short training courses and manuals of manufacturing guidelines to introduce professionals to the use of its polypropylene technology.
In addition, the ICRC Special Fund for the Disabled has helped accredited schools -those classified by the ISPO as "Category II" -to incorporate polypropylene technology into their curricula. 9

# LOWER LIMB PROSTHETICS

# Physical Rehabilitation Programme

# PROSTHETICS & ORTHOTICS MANUFACTURING GUIDELINES

# Using polypropylene technology

# UPPER LIMB PROSTHETICS

# Physical Rehabilitation Programme

# PROSTHETICS & ORTHOTICS MANUFACTURING GUIDELINES

# Using polypropylene technology

# LOWER LIMB ORTHOTICS

# Physical Rehabilitation Programme

# PROSTHETICS & ORTHOTICS MANUFACTURING GUIDELINES

# Using polypropylene technology

# TRAINING RESOURCES
Every year, ICRC-supported physical rehabilitation centres use the organization's polypropylene technology to produce tens of thousands of orthopaedic appliances throughout the world. A large number of non-governmental organizations have also adopted this technology.
Over the years, several test reports published by the ISPO have endorsed the ICRC's polypropylene technology for use in developing countries. 2 The ICRC constantly monitors the performance of its various orthopaedic products to ensure their high quality.
The ICRC's efforts to widen the range of its products through research conducted together with its supplier 3 and to improve its polypropylene technology are unceasing. As a result, these devices have benefited recently: knee and hip disarticulation prosthetic joints and prosthetic feet for long trans-tibial stumps.

# A CONSTANTLY EVOLVING TECHNOLOGY
Polypropylene was discovered in the early 1950s by an Italian chemist, in 1963.
In 1957, polypropylene was produced industrially by the Italian chemical company, Montecatini. Its overproduction and its low cost resulted in many commercial uses being found for the new material. In modern science, inventions often occur in different places simultaneously. Polypropylene is an extreme instance of this phenomenon: it was independently invented about nine times. It is a near sibling to one of its predecessors, polyethylene. Like polyethylene, polypropylene is inexpensive, but it is much more rugged. It is a thermoplastic polymer with many applications -from plastic bottles to carpets to plastic furniture -and is very heavily used in automobiles.
Two types of polypropylene are used in prosthetics and orthotics:

# Co-polymer

# Homopolymer
Polypropylene can't be dissolved and is difficult to glue. It is UV-sensitive but certain additives can make it more resistant. It becomes more brittle at low temperatures.
Polypropylene can be made less brittle and more flexible by means of co-polymerization with polyethylene.

# ABOUT POLYPROPYLENE TECHNOLOGY PUBLIC ATIONS AND FILMS
More ICRC publications, technical resources and fi lms are available on www.icrc.org

# Physical Rehabilitation Programme

# TRANS-FEMORAL PROSTHESIS

# MANUFACTURING GUIDELINES

# MISSION
The International Committee of the Red Cross (ICRC) is an impartial, neutral and independent organization whose exclusively humanitarian mission is to protect the lives and dignity of victims of armed conflict and other situations of violence and to provide them with assistance. The ICRC also endeavours to prevent suffering by promoting and strengthening humanitarian law and universal humanitarian principles. Established in 1863, the ICRC is at the origin of the Geneva Conventions and the International Red Cross and Red Crescent Movement. It directs and coordinates the international activities conducted by the Movement in armed conflicts and other situations of violence.