Better practical evaluation for lower limb amputees.
OBJECTIVE
To avoid wastage of prostheses and unfair selection methods for prosthetic prescription, we aimed to develop a practical assessment tool for amputees with doubtful potential, using refurbished second hand modular prostheses.


METHODS
Thirty-seven primary amputees (33 transfemoral, 4 transtibial; 22 males, 15 females; median age 71 years, range 19-91) were considered to have doubtful potential for prosthetic use, due to single or multiple impairments. Amputees were assessed using custom-made socket and refurbished second-hand modular prostheses. Liability issues were fully covered.


RESULTS
Two patients died before completing the assessment. Median duration of assessment was 4 weeks (range 1-31 weeks). Among the 35 amputees who completed the trial, 14 (38%) proceeded to final prosthesis successfully and 21 (58%) decided to abandon the prostheses. The main reasons for prostheses rejection identified by the team were: hip flexion deformity (4); frailty (4); bilateral amputations (4); COAD (6), stroke (4), stump pain (3) and contralateral leg problems (2)


CONCLUSIONS
High prosthetic rejection rate was expected and confirmed in this group (58%), but considerable number did proceed to definitive prosthesis. The method is practical and fair for amputees of doubtful potential, with considerable cost saving.
Marzoug
E A
EA
King's College Hospital. eltahirmarzoug@hotmail.com
Landham
T L
TL
Dance
C
C
Bamji
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AN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000672:Amputation Stumps / Q000503:physiopathology; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D005260:Female; D016330:Frail Elderly; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D020521:Stroke / Q000150:complications