90.21 ‑ Orthopaedic appliances, including crutches, surgical belts and trusses; splints and other fracture appliances; artificial parts of the body; hearing aids and other appliances which are worn or carried, or implanted in the body, to compensate for a defect or disability.

(Ⅰ) ORTHOPAEDIC APPLIANCES
Orthopaedic appliances are defined in Note 6 to this Chapter. These are appliances for :
- Preventing or correcting bodily deformities; or
- Supporting or holding parts of the body following an illness, operation or injury.
They include :

(1) Appliances for hip diseases (coxalgia, etc.).

(2) Humerus splints (to enable use of an arm after resection), (extension splints).

(3) Appliances for the jaw.

(4) Traction, etc., appliances for the fingers.

(5) Appliances for treating Pott's disease (straightening head and spine).

(6) Orthopaedic footwear and special insoles designed to correct orthopaedic conditions, provided that they are either (1) made to measure or (2) mass-produced, presented singly and not in pairs and designed to fit either foot equally.

(7) Dental appliances for correcting deformities of the teeth (braces, rings, etc.).

(8) Orthopaedic foot appliances (talipes appliances, leg braces, with or without spring support for the foot, surgical boots, etc.).

(9) Trusses (inguinal, crural, umbilical, etc., trusses) and rupture appliances.

(10) Appliances for correcting scoliosis and curvature of the spine as well as all medical or surgical corsets and belts (including certain supporting belts) characterised by :

(a) Special pads, springs, etc., adjustable to fit the patient.

(b) The materials of which they are made (leather, metal, plastics, etc.); or

(c) The presence of reinforced parts, rigid pieces of fabric or bands of various
widths.
The special design of these articles for a particular orthopaedic purpose distinguishes them from ordinary corsets and belts, whether or not the latter also serve to support or hold.

(11) Orthopaedic suspenders (other than simple suspenders of knitted, netted or crocheted materials, etc.).
This group also includes crutches and crutch‑sticks. (It should, however, be noted that ordinary walking‑sticks, even if specially made for disabled persons, are excluded (heading 66.02).)
This group further includes walking aids known as "walker-rollators", which provide support for the users as they push them. They generally consist of a tubular metal frame on three or four wheels (some or all of which may swivel), handles and hand-brakes. "Walker-rollators" can be adjustable in height and can be equipped with a seat between the handles and with a wire basket for carrying personal items. The seat allows the user to take short rest breaks whenever necessary.
The heading does not include :

(a) Stockings for varicose veins (heading 61.15).

(b) Simple protectors or devices designed to reduce pressure on certain parts of the foot,
(heading 39.26, if made of plastics, or heading 40.14, if of cellular rubber fixed on gauze with adhesive plaster).

(c) Supporting belts or other support articles of the kind referred to in Note 1 (b) to this Chapter, e.g., pre‑natal or maternity belts (generally heading 62.12 or 63.07).

(d) Mass‑produced footwear the inner soles of which have been simply arched to alleviate flat‑footedness (Chapter 64).
This group also covers orthopaedic appliances for animals, for example, hernia trusses or straps; leg or foot fixation apparatus; special straps and tubes to prevent animals from crib‑biting, etc.; prolapsus bands (to retain an organ, rectum, uterus, etc.); horn supports, etc. But it excludes protective devices having the character of articles of ordinary saddlery and harness for animals (e.g., shin pads for horses) (heading 42.01).

(Ⅱ) SPLINTS AND OTHER FRACTURE APPLIANCES
Fracture appliances are used either to immobilise injured parts of the body (for extension or protection), or for setting fractures. They are also used in the treatment of dislocations and other joint injuries.
Some of these articles are designed for fitting onto the patient (e.g., wire, zinc or wooden cradles for holding limbs, plaster bandage splints, fracture appliances for ribs, etc.); others are designed to be fixed to a bed, a table or another support (protective bed cradles, extension fracture apparatus made of tubing, to be used in the place of splints or cradles, etc.). However, when the latter appliances form an inseparable part of the bed, table or another support, they are excluded from this heading.
Subject to the provisions of Note 1 (f) to this Chapter, the heading also includes plates, nails, etc., which are inserted inside the human body by surgeons to hold together the two parts of a broken bone or for similar treatment of fractures.

(Ⅲ) ARTIFICIAL LIMBS, EYES, TEETH AND OTHER ARTIFICIAL PARTS OF THE BODY
These wholly or partially replace defective parts of the body and usually resemble them in appearance. They include :

(A) Artificial ocular fittings :

(1) Artificial eyes. These are usually made of plastics or glass to which small quantities of metallic oxides have been added in order to imitate the features and colouring of the various parts of the human eye (sclera, iris, pupil). They may be of single or of double shell types.

(2) Intra‑ocular lenses.
Artificial eyes for tailors' dummies, for furs, etc., are excluded (generally classified in heading 39.26 or 70.18); artificial eyes identifiable as parts of dolls or of toy animals fall in heading 95.03 or in heading 70.18, if they are of glass.

(B) Artificial teeth and dental fittings, for example :

(1) Solid artificial teeth, usually made of porcelain or plastics (acrylic polymers in particular). These may be "diatoric" teeth having a small number of holes into which the fixing material penetrates (generally molars), or may be fitted with two metallic pins for fixing (generally incisors and canines) or with a groove for sliding on to a metal ridge fixed to the dental plate (also usually incisors and canines).

(2) Hollow artificial teeth, also made of porcelain or plastics and with the external shape of teeth (incisors, canines or molars).
According to the method of fixing, they are called "pivot teeth" (placed on a small metallic pin or pivot fitted into the prepared root), or "crowns" (fitted by means of artificial resin on to a previously shaped stump).

(3) Dentures, whole or part, comprising a plate of vulcanised rubber, plastics or metal to which the false teeth are fitted.

(4) Other articles such as, prefabricated metal crowns (gold, stainless steel, etc.) used for the protection of real teeth; cast tin bars ("heavy bars") for weighting and increasing the stability of dentures; stainless steel bars for reinforcing vulcanised rubber dental plates; various other dentists' accessories, clearly identifiable as such, for making metal crowns or dentures (sockets, rings, pivots, hooks, eyelets, etc.).
It should be noted that dental cements and other dental fillings fall in heading 30.06; the preparations known as "dental wax" or as "dental impression compounds", put up in sets, in packings for retail sale or in plates, horseshoe shapes, sticks or similar forms, and other
preparations for use in dentistry, with a basis of plaster (of calcined gypsum or calcium sulphate), fall in heading 34.07.

(C) Other artificial parts of the body, e.g., arms, forearms, hands, legs, feet, noses, artificial joints (e.g., for hips, knees), and tubes of synthetic fabric for replacing blood vessels and heart‑valves.
The heading excludes pieces of bone or skin for grafting, in sterile containers (heading 30.01) and bone reconstruction cements (heading 30.06).

(Ⅳ) HEARING AIDS
These are generally electrical appliances with a circuit containing one or more microphones (with or without amplifier), a receiver and a battery. The receiver may be worn internally or behind the ear, or it may be designed to be held in the hand against the ear.
This group is restricted to appliances for overcoming deafness; it therefore excludes articles such as headphones, amplifiers and the like used in conference rooms or by telephonists to improve the audibility of speech.

(Ⅴ) OTHER APPLIANCES WHICH ARE WORN OR CARRIED, OR IMPLANTED IN THE BODY, TO COMPENSATE FOR A DEFECT OR DISABILITY
This group includes :

(1) Speech‑aids for persons having lost the use of their vocal cords as a result of an injury or a surgical operation. These consist essentially of an electronic impulse generator. When pressed against the neck, for example, they generate vibrations in the cavities of the throat which are modulated by the user to produce audible speech.

(2) Pacemakers for stimulating defective heart muscles. These are roughly the size and weight of a pocket watch and are implanted beneath the skin of the patient's chest. They incorporate an electric battery and are connected by electrodes to the heart, which they provide with the impulses necessary for its functioning. Other types of pacemakers are used to stimulate other organs (for example, the lungs, the rectum or the bladder).

(3) Electronic aids for the blind. These consist essentially of an ultrasonic transmitter‑receiver powered by an electric battery. The frequency variations resulting from the time taken for the ultrasonic beam to travel out to an obstacle and be reflected back enable the user, through an appropriate device (e.g., an internal ear‑piece), to detect the obstacle and judge its distance.

(4) Appliances implanted in the body, used to support or replace the chemical function of certain organs (e.g., secretion of insulin).

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