Stand tall

In an examination room equipped with hand bars, a full-length mirror, a few inspirational posters, Don Harway sits in a chair. He has on shorts. He usually wears shorts. He has nothing to hide.

His right leg is gone, cut off just below the knee, the result of a motorcycle accident. The stump, called the "residual limb" in polite medical terms, looks a bit pinkish and chafed. The muscles in his thigh are still in the process of atrophy and change.

Harway, 36, sits in the chair and rubs his exposed stump. He can move it back and forth. Admittedly, it's an odd spectacle – this completely responsive, functional knee, attached to nothing, kicking air. Even so, in his mind, in the phenomenon known as "phantom limb," Harway can still feel the kinship, the majesty of his toes. There is no pain, just an aching regret.

Now he slips on a gel-lined sleeve over his stump. The bottom of the sleeve holds a metal locking pin. His prosthetist, Bryan Hayes, hands Harway his new prosthesis, which consists of a plastic socket, a leaf-spring ankle, a splayed, carbon-fiber foot, now snug inside a khaki-green Nike running shoe.

Harway slips his stump into the prosthesis. There is an audible "click." Now he stands like a man.

This is the story of Don's leg.

On another afternoon, Bryan Hayes sits in his office at Hanger Prosthetics & Orthotics, which is at 1248 32nd St. He is holding a foot in his hand. Not a real foot. But a graphite composite foot, a marvel of stability, pace, clad in soft foam flesh.

Attached to a pivoting, piston-driven hydraulic ankle, this foot puts measurable spring in the step.

Hayes is 37 years old. He's a certified prosthetist. He's sturdy, laconic, with blue eyes and a reddish goatee. "As a kid, I was always fascinated by the human body," he says. "And I always liked to work on cars. So, this field is the perfect combination. I like to help people. I like to build stuff. Building a leg is like fine-tuning a race car."

Hanger is a historic company. It was founded in 1861 by James Edward Hanger, a Confederate veteran who lost his leg in the Civil War, the Golden Age of amputation. Hanger, unhappy with the quality of artificial limbs at the time – think peg legs and broomsticks – whittled a shapely leg from a barrel stave. His popular leg became known as the "Hanger limb."

(The art of prosthetics, of course, goes back centuries. The oldest limb ever discovered, made of copper and wood, circa 300 B.C., was untombed in Italy. The first articulated knee was made out of metal in the 15th century, by the same medieval tailors who hammered those bespoke suits of armor.)

Today, Hanger, with 660 offices nationwide, is the largest provider of prosthetics in the country. Hayes, a graduate of the University of California, Davis, who has a degree in prosthetics/orthotics from Northwestern University, is the practice manager of the Sacramento office.

Sacramento is Hanger's busiest office on the West Coast. Each year, it fabricates, in house, upward of 200 lower- extremity prostheses, 60 percent of which are limbs for below the knee. Surgeons, whenever possible, strive to save the knee. It usually takes two weeks to make an average leg, and, depending on range of motion, prosthetics can cost $6,000 to $60,000.

In a seemingly prehistoric age, which wasn't that long ago, prosthetists made leg sockets from carved willow, cast residual limbs using plaster. Modified the fittings with files, chisels, intuition.

Today, Hayes uses a laser scanner to measure a perfect, three-dimensional image of the stump, which he can then digitally shape and alter on his laptop computer. Once satisfied, he e-mails the image to a carving machine, which, using a block of high-density foam, cuts the block to size as if it were a Chippendale leg.

From there, using the whole spectrum of Space Age materials – titanium, thermoplastics, composites, Kevlar, fast- setting resins, hydraulics, myoelectrics – technicians can then build a prosthetic device with almost lifelike function and flexibility.

About the writer:

• Call The Bee's Bob Sylva, (916) 321-1135.