Better practical evaluation for lower limb amputees. 2003

E A Marzoug, and T L Landham, and C Dance, and A N Bamji
King's College Hospital. eltahirmarzoug@hotmail.com

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.

UI MeSH Term Description Entries
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010146 Pain An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS. Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D011475 Prosthesis Failure Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking. Prosthesis Loosening,Prosthesis Durability,Prosthesis Migration,Prosthesis Survival,Durabilities, Prosthesis,Durability, Prosthesis,Failure, Prosthesis,Failures, Prosthesis,Loosening, Prosthesis,Loosenings, Prosthesis,Migration, Prosthesis,Migrations, Prosthesis,Prosthesis Durabilities,Prosthesis Failures,Prosthesis Loosenings,Prosthesis Migrations,Prosthesis Survivals,Survival, Prosthesis,Survivals, Prosthesis
D005260 Female Females
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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