title: Prosthesis rejection in acquired major upper-limb amputees: a population-based survey.
abstract: OBJECTIVE
  To estimate the rates of primary and secondary prosthesis rejection in acquired major upper-limb amputees (ULAs), to describe the most frequently reported reasons for rejection and to estimate the influence of background factors on the risk of rejection.
  
  
  METHODS
  Cross-sectional study analysing population-based questionnaire data (n = 224). Effects were analysed by logistic regression analyses and Cox regression analyses.
  
  
  RESULTS
  Primary prosthesis rejection was found in 4.5% whereas 13.4% had discontinued prosthesis use. The main reasons reported for primary non-wear were a perceived lack of need and discrepancies between perceived need and the prostheses available. The main reasons reported for secondary prosthesis rejection were dissatisfaction with prosthetic comfort, function and control. Primary prosthesis rejection was more likely in ULAs amputated at high age and in ULAs with proximal amputations. Secondary prosthesis rejection was more likely in proximal ULAs and in women.
  
  
  CONCLUSIONS
  Clinicians should be aware of the increased risk of rejection in proximal ULAs, elderly ULAs and in women. Emphasising individual needs will probably facilitate successful prosthetic fitting. Improved prosthesis quality and individualised prosthetic training may increase long-term prosthesis use. Further studies of the effect of prosthetic training and of the reasons for rejection of different prosthetic types are suggested.
authors: Innlandet Hospital Trust, Department of Physical Medicine and Rehabilitation, Ottestad, Norway. kristin.ostlie@sykehuset-innlandet.no
authors: Kristin
authors: K
authors: Østlie
authors: Ingrid Marie
authors: IM
authors: Lesjø
authors: Rosemary Joy
authors: RJ
authors: Franklin
authors: Beate
authors: B
authors: Garfelt
authors: Ola Hunsbeth
authors: OH
authors: Skjeldal
authors: Per
authors: P
authors: Magnus
mesh_terms: D000674:Amputees / Q000534:rehabilitation* / Q000706:statistics & numerical data; D001132:Arm / Q000601:surgery*; D001186:Artificial Limbs / Q000523:psychology* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D017060:Patient Satisfaction; D011159:Population Surveillance; D012059:Rejection, Psychology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires