title: Bariatric amputee: A growing problem?
abstract: BACKGROUND
  This study reviewed prevalence of patients with lower limb amputations with above normal weight profile, with body mass index over 25, in seven disablement services centres managing their amputee rehabilitation in the United Kingdom.
  
  
  OBJECTIVE
  To review two clinical standards of practice in amputee rehabilitation. Ambulant lower limb amputees should have their body weight recorded on an electronic information system, with identification of cohort with body weight >100 kg. Lower limb amputees to be provided with suitable weight-rated prosthesis.
  
  
  METHODS
  Observational study of clinical practice.
  
  
  METHODS
  Data were collected from the Clinical Information Management Systems. Inclusion criteria--subjects were ambulant prosthetic users with some prosthetic intervention in the last 5 years and had at least one lower limb amputation.
  
  
  RESULTS
  In 96% of patients, the weight record profile was maintained. In addition, 86% were under 100 kg, which is the most common weight limit of prosthetic componentry. Of 15,204 amputation levels, there were 1830 transfemoral and transtibial sites in users with body weight over 100 kg. In 60 cases, the prosthetic limb build was rated to be below the user body weight.
  
  
  CONCLUSIONS
  In 96% of our patients, body weight was documented, and in 97%, the prosthetic limb builds were within stated body weight limits, but this may not be the case in all the other disablement services centres in the United Kingdom. Also, the incidence of obesity in the United Kingdom is a growing problem, and the health issues associated with obesity are further compounded in the amputee population.
  
  
  CONCLUSIONS
  Prosthetic componentry has distinct weight limits which must be considered during prescription. As people with amputation approach the limits of specific components, clinicians are faced with the challenge of continued provision in a safe and suitable manner. This article reviews the amputee population and the current national profile to consider trends in provision and the incidence of these challenges.
authors.affiliation: Disablement Services Centre (DSC), University Hospitals of South Manchester, Manchester, UK jai.kulkarni@uhsm.nhs.uk.
authors.forename: Jai
authors.initials: J
authors.lastname: Kulkarni
authors.affiliation: Opcare Ltd, Manchester, UK.
authors.forename: Dominic P
authors.initials: DP
authors.lastname: Hannett
authors.affiliation: Opcare Ltd, Manchester, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Purcell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data / Q000639:trends*; D000674:Amputees / Q000706:statistics & numerical data; D001186:Artificial Limbs / Q000706:statistics & numerical data / Q000639:trends*; D049088:Bariatrics; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D035002:Lower Extremity / Q000601:surgery*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Bariatric amputees; artificial limb; prosthetic rehabilitation