Rehabilitation after lower limb amputation: a comparative study of above-knee, through-knee and Gritti-Stokes amputations.
A study of 169 unilateral amputees under three Disablement Services Centres was performed. The study comprised 88 above-knee, 54 through-knee and 27 Gritti-Stokes amputations. Satisfactory rehabilitation occurred in 33 per cent of above-knee, 62 per cent of through-knee and 44 per cent of Gritti-Stokes patients (56 per cent overall). The better rehabilitation of through-knee versus above-knee amputees (P less than 0.02) was also found in a group of patients matched for comparable age and duration of amputation as well as in a group of age-matched vascular amputees. Through-knee amputees relied significantly less on wheelchairs than above-knee (P = 0.016) and Gritti-Stokes (P = 0.05) amputees. The prosthesis used for the through-knee and Gritti-Stokes amputations was considered unsightly in 50 per cent of cases (versus 31 per cent for the above-knee prosthesis). The superior rehabilitation with through-knee amputations should prompt us to improve both our technique for this amputation and the prostheses currently available. A through-knee amputation should be performed in preference to an above-knee amputation in the case where either is surgically possible, and a below-knee amputation not feasible.
Department of Surgery, Guy's Hospital, London, UK.
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A
Houghton
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A
Allen
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R
Luff
I
I
McColl
D000328:Adult; D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation*; D001186:Artificial Limbs; D005260:Female; D006801:Humans; D007717:Knee; D007866:Leg / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011474:Prosthesis Design; D013997:Time Factors; D014910:Wheelchairs