The bone mineral density and isokinetic knee strength in amputee soccer players

SUMMARY OBJECTIVE: The aim of this study was to examine the isokinetic knee strength, H/Q ratio (%), and bone mineral density values between amputees (n=14; amputee soccer players) and healthy football players (n=14; non-amputee soccer players). METHODS: A total of 28 amputee soccer players and non-amputee soccer players participated in the study. An isokinetic dynamometer was used to determine the knee flexion/extension forces of the dominant legs of the athletes at 60, 180, and 240°/s. Bone mineral density scans were performed using dual-energy X-ray absorptiometry. RESULTS: H/Q ratio and 60º/s flexion and 180 and 240º/s flexion/extension strength (p<0.05) were found to be high (180º/s, p=0.03; 240º/s, p=0.048) in the non-amputee soccer player group. Accordingly, the bone mineral density values of the lumbar vertebra, femoral neck, proximal metaphysis of the femur (p<0.01), tibia/fibula proximal metaphysis, and tibia/fibula distal metaphysis (p<0.05) were found to be high. A correlation was observed between the 60º/s knee extension strength and tibia/fibula diaphyseal bone mineral density (p=0.025; r=0.594) and tibia/fibula distal metaphysis bone mineral density (p=0.017; r=0.623) values in the amputee soccer players group. The Z-scores of the amputee soccer players and non-amputee soccer players were in the expected range according to age (>-2). CONCLUSION: The bone mineral density, H/Q ratio, and all measured angular velocities of isokinetic strength were high in non-amputee soccer players. This finding made us think that lower extremity amputation may also be associated with losing strength. However, it was observed that the relationship between strength and bone mineral density in amputee athletes might vary according to different angular velocities. It is recommended that isokinetic strength measurement can be evaluated together with bone mineral density in athletes.

Physical activity and quality of life in adults and elderly individuals with lower limb amputation

SUMMARY OBJECTIVE: The aim of this study was to investigate the levels of physical activity (PA) and quality of life (QOL) in adults and elderly individuals with lower limb amputation (LLA). METHODS: This was a cross-sectional observational study. Participants completed three surveys as follows: a demographic survey, the International Physical Activity Questionnaire, and the World Health Organization Quality of Life. Thirty-six individuals with lower limb amputation were separated into two different groups as follows: Adults-lower limb amputation (n=12), composed of individuals with lower limb amputation who aged from 18-59 years, and Elderly-lower limb amputation (n=24), composed of individuals with lower limb amputation who aged 60 years and above. Statistical differences were determined as p<0.05. RESULTS: Age and number of individuals with a low level of functional independency were higher in the Elderly-lower limb amputation group (p<0.05). The International Physical Activity Questionnaire scores were reduced in the Elderly-lower limb amputation group (p<0.05). The Pearson's correlation test between low metabolic equivalent task (MET), time since amputation, and family income presented positive significant results in the Elderly-lower limb amputation (p<0.05). Adults-lower limb amputation just presents a positive significant correlation with the low family income (p<0.05). CONCLUSION: Elderly individuals with lower limb amputation are more susceptible to present negative health outcomes than adults with lower limb amputation.

Assessment of the upper limbs maximum power and the locomotion speed in amputee football players

Abstract Aim: The purpose of the study was to assess upper limbs' maximum power and locomotion speed among amputee football (amputee soccer) players. Methods: The 30-s Wingate Anaerobic test and the 20-m sprint test were performed. Anthropometric measurements and body composition (Body mass index (BMI), percentage of body fat (% BF), and lean body mass (LBM)) were examined. Results: BMI significantly differentiated forwards and defenders (p < 0.05). Peak power (PP) and mean power (MP) were related to LBM (p < 0.05), thus defenders reached higher values of PP, in comparison to forwards. % BF and BMI were related to relative mean power (rMP) (p < 0.05). Field position differentiated players in terms of upper limbs' relative peak power (rPP) in favour of forwards (p < 0.05). Age was a significant factor for speed velocity on 10 m and 20 m (p < 0.05). There was no relationship between upper limbs' power and locomotion speed. Conclusion: Body composition, especially % BF may influence on the anaerobic performance of amputee football players.

Patient-Specific Design of Passive Prosthetic Leg for Transtibial Amputee: Analysis Between Two Different Designs

@#Introduction: Amputee patients are usually utilized prosthetic leg for daily activities such as walking, climbing, and running. However, the current prosthetic leg that available from the market often associated with poor comfortability due to its conventional way of socket manufacturing. Therefore, this research aims to build custom-made passive transtibial prosthetic legs and to evaluate the aspects of biomechanical analysis. Methods: The residual leg of a subject was scanned using the Sense three-dimensional scanner. By referring to scanned residual leg model, two design of prosthetic legs which are the low-cost solid ankle cushion heel (SACH) foot (D1), and the high-cost flex foot (D2), were developed by using computer aided software (CAD), SolidWorks and Meshmixer. Each of the components were then meshed with triangle edge length of 5 mm in 3-Matic software. Marc.Mentat software was used to simulate the midstance phase of a gait cycle where an axial load of 350 N was applied. Results: The overall maximum stress of the D1 (190.2 MPa) was higher than D2 (38.47 MPa). In addition, socket and pylon in D1 showed tendency to yield because the maximum stress is higher than yield stress of respective materials. In displacement analysis, D2 showed higher overall displacement than D1 because the flex foot has higher flexibility. Conclusion: From overall result, prosthetic leg of D2 is better in biomechanical strength as compared with the D1 because it can withstand the loading from subject’s weight without showing any sign of yield.

Programa de ejercicios físicos terapéuticos para pacientes amputados / Programa de exercícios físicos terapêuticos para pacientes amputados / Therapeutic physical exercises program for amputees

Resumen El proceso de rehabilitación para los pacientes amputados carece de un instrumento metodológico para el desarrollo de la fuerza muscular que les permitan alcanzar mejores niveles de marcha y equilibrio. Por tal motivo, se elaboró un programa de desarrollo de la fuerza muscular dirigido a alcanzar mejores niveles de marcha y equilibrio del paciente amputado. Se analizaron los fundamentos teóricos y metodológicos del tratamiento físico rehabilitador del paciente amputado para establecer el diagnóstico del tratamiento. Asimismo, se determinó la estructura, contenido y metodología del programa, el cual fue valorado por criterio de expertos. El estudio fue de corte descriptivo de naturaleza holística, con un diseño no experimental. La muestra fue de 19 especialistas, seis fisiatras con más de nueve años de experiencia, diez rehabilitadores con más de ocho años de experiencia, un ortopédico y un Doctor en Ciencia de la Cultura Física con más de seis años de experiencia, con una edad promedia de 45 años, presentando un alto dominio y nivel de conocimientos sobre el tema. Los métodos aplicados fueron teóricos y empíricos. Se estructuró el programa de ejercicios físico-terapéuticos para pacientes amputados. Los expertos valoraron de muy adecuado la pertinencia e implementación del programa de ejercicios físico-terapéuticos para pacientes amputados con una efectividad esperada fuerte. Resultó pertinente la confección del programa, ya que justifica la necesidad de orientar científica y metodológicamente a los rehabilitadores físicos.

Resumo O processo de reabilitação de pacientes amputados carece de um instrumento metodológico para o desenvolvimento da força muscular que lhes permita alcançar melhores níveis de marcha e equilíbrio. Por esta razão, foi desenvolvido um programa de desenvolvimento da força muscular para alcançar melhores níveis de marcha e equilíbrio para o paciente amputado. Os fundamentos teóricos e metodológicos do tratamento de reabilitação física do paciente amputado foram analisados para estabelecer o diagnóstico do tratamento. Do mesmo modo, a estrutura, conteúdo e metodologia do programa foram determinados e avaliados por critérios de peritos. O estudo foi descritivo e holístico por natureza, com um desenho não experimental. A amostra foi composta por 19 especialistas, 6 fisiatras com mais de 9 anos de experiência, 10 reabilitadores com mais de 8 anos de experiência, um ortopedista e um Doutor em Ciências da Cultura Física com mais de 6 anos de experiência, com uma idade média de 45 anos, apresentando um elevado nível de domínio e conhecimentos sobre o assunto. Os métodos aplicados eram teóricos e empíricos. O programa de exercícios físico-terapêuticos para pacientes amputados foi estruturado. Os peritos avaliaram a relevância e a implementação do programa de exercícios de fisioterapia para pacientes amputados com uma forte eficácia esperada. A preparação do programa foi pertinente, uma vez que justifica a necessidade de uma orientação científica e metodológica para os profissionais de reabilitação física.

Abstract The rehabilitation process for amputees lacks a methodological instrument for developing muscular strength that allows them to achieve better levels of walking and balance. For this reason, a muscle strength development program was designed to achieve better gait and balance levels for the amputee. The theoretical and methodological foundations of the rehabilitating physical treatment of the amputee patient were analyzed to establish the diagnosis of the treatment. The structure, content and methodology of the program were also determined. Which was valued by expert judgment. The study was descriptive in a holistic nature with a non-experimental design. The sample was of 19 specialists, six physiatrists with more than nine years of experience, ten rehabilitators with more than eight years of experience, an orthopedic and a Doctor of Science in Physical Culture with more than six years of experience, with an average age 45 years old, presenting a domain and level of knowledge on topic four obtained a medium and a high coefficient of 15. The applied methods were theoretical and empirical. The physical-therapeutic exercise program for amputated was structured. The experts rated the relevance and implementation of the physical-therapeutic exercise program for amputees with a strong expected effectiveness as very adequate. The preparation of the program was pertinent, since it justifies the need to guide the physical rehabilitators scientifically and methodologically. Conclusions and recommendations were reached.

Effects of Prosthetic Alignment on Internal Contact Mechanical Characteristics of Intact Knee Joints for Transfemoral Amputees / 医用生物力学

Objective To study the effects of prosthetic alignment on internal contact mechanical characteristics of intact knee joint for transfemoral amputees. Methods The gait experiment of transfemoral amputees was performed under different alignment conditions, and the differences of lower limb motion and ground reaction force (GRF) were analyzed and compared with those of the non-amputees. The three-dimensional （30） finite element model of knee joint was build and used to analyze the effect of alignments of socket adduction and abduction on internal contact mechanical characteristics between femur cartilage, tibia cartilage and meniscus. Results For knee joint of the non-amputees, contact force was mainly concentrated on the medial sides at the moment of the first GRF peak, while contact force was mainly concentrated on the lateral sides at the moment of the second GRF peak. However, for intact knee joint of the transfemoral amputees, contact force was mainly concentrated on the medial side at the moment of two GRF peaks. The stress of the medial meniscus, contact force and contact area between the medial meniscus and cartilage all obviously increased under the alignment of 6° socket adduction. Conclusions Compared with non-amputees, the incidence of knee osteoarthritis (OA) in amputees was higher, which was related to the long-term overload of the medial knee joint. The alignment of socket adduction may increase the risk of knee OA in the intact side of transfemoral amputees. In clinic, excessive adduction of the socket should be avoided during prosthetic alignment.

Walking Ability of an Unilateral Transfemoral Amputee with Four Kinds of Prosthetic Knee Joints / 中国康复理论与实践

Objective To compare the walking abilities of an unilateral transfemoral amputee with four different prosthetic knee joints, to provide a reference for clinical prosthetic prescription. Methods An unilateral transfemoral amputee was asked to wear four kinds of pros-thetic knee joints, mechanical four-bar, pneumatic four-bar, hydraulic and intelligent prosthetic knee joints, and evaluated with Timed Up and Go Test, indoor 6-Minute Walk Test, Static Stand Balance Test and a 1000-meter Outdoor Walking Ability Test, wearing Intelligent De-vice for Energy Expenditure and Activity. Results The amputee consumed the least energy and walked the fastest with intelligent prosthetic knee joint. Conclusion There are some difference in walking ability with different prosthetic knee joints.

Walking Ability of an Unilateral Transfemoral Amputee with Four Kinds of Prosthetic Knee Joints / 中国康复理论与实践

Objective To compare the walking abilities of an unilateral transfemoral amputee with four different prosthetic knee joints, to provide a reference for clinical prosthetic prescription. Methods An unilateral transfemoral amputee was asked to wear four kinds of pros-thetic knee joints, mechanical four-bar, pneumatic four-bar, hydraulic and intelligent prosthetic knee joints, and evaluated with Timed Up and Go Test, indoor 6-Minute Walk Test, Static Stand Balance Test and a 1000-meter Outdoor Walking Ability Test, wearing Intelligent De-vice for Energy Expenditure and Activity. Results The amputee consumed the least energy and walked the fastest with intelligent prosthetic knee joint. Conclusion There are some difference in walking ability with different prosthetic knee joints.

Investigation of amputees with prosthetic limbs at our hospital / Journal of Rural Medicine

<p><b>Objectives:</b> This study was performed to elucidate the characteristics of amputees in our hospital. We also evaluated whether the causes and characteristics of the amputations influenced the patients’ prosthetic walking ability.</p><p><b>Materials and Methods:</b> We retrospectively examined 47 amputees in our hospital from December 1996 to April 2016 with respect to the causes and levels of amputation. Of 28 lower limb amputees from April 2008 to April 2016, 22 received prostheses and were divided into 2 groups according to the cause of the amputation, as follows: the internal cause group (e.g., vascular deficiency and infection) and the external cause group (e.g., trauma, burn injury, and crush syndrome). The characteristics and process of achieving prosthetic ambulation were compared between these groups.</p><p><b>Results:</b> Trauma was the most common cause of both upper (70.0%) and lower limb amputations (40.5%). Unilateral amputation was performed in 93.2% of patients (upper limb amputation, 100.0%; lower limb amputation, 91.9%). Patients were older in the internal than in the external cause group (<i>P</i> = 0.026). The serum albumin (<i>P</i> = 0.003) and total cholesterol concentrations (<i>P</i> = 0.046) on admission were significantly lower in the internal than in the external cause group. All patients in the internal cause group had comorbidities. The proportions of patients with diabetes mellitus (<i>P</i> = 0.011) and cerebrovascular disease (<i>P</i>=0.036) were significantly higher in the internal than in the external cause group. No significant difference in walking ability was found between the internal and external cause groups at the time of discharge.</p><p><b>Conclusion:</b> Most amputees in our hospital underwent unilateral lower limb amputation due to trauma. Although the patients with internal causes of amputation were older, more frequently had malnutrition, and had more comorbidities than those with external causes, they achieved prosthetic walking with statistically insignificant difference at the end of hospitalization, excluding six patients who had no prosthetic prescription.</p>

Effects of leg length discrepancy on gait: An experimental study / 医用生物力学

Objective To simulate leg length discrepancy by unilateral increase in lower limb of normal person, analyze gait features in the case of leg length discrepancy and its effect on walking gait, so as to provide theoretical proofs for chronical musculoskeletal diseases in lower limb amputees due to leg length discrepency. Methods Leg length discrepancy was simulated by subjects wearing shoes to increase the unilateral height of one leg. The time-space parameters, ground reaction forces and joint angles of the subjects during normal walking gait and leg length discrepancy gait were obtained via the 3D motion capture system and the reaction force platform to make comparative analysis. Results Significant differences were found between leg length discrepancy gait and normal gait in terms of step length, stride time and single supporting period. In the case of leg length discrepancy gait, the ground reaction force of both feet significantly increased at heel-strike phase compared with normal gait, and obvious changes were observed in angles of hip, knee and ankle joints. Conclusions Leg length discrepancy is an important cause leading to gait abnormalities, and maybe a cause of leg joint diseases for trans-tibial amputees wearing prosthesis.

Prevalencia de inserción laboral en la adultez de pacientes amputados antes de los 18 años de edad y factores clínico-demográficos asociados: Instituto Teletón Santiago 2012-2013 / Job integration prevalence in adulthood of patients amputated before 18 years of age and associated clinical-demographic factors: Santiago Teletón Institute, 2012-2013

Introducción: el integro laboral es una meta primordial en la rehabilitación; en pacientes amputados fluctúa entre 43 y 89 por ciento. Existen factores descritos que se asocian a empleabilidad como género, edad a la que fueron amputados, nivel educacional, uso de prótesis, dolor, nivel de amputación y número de extremidades comprometidas. No se han encontrados estudios en pacientes amputados en edad pediátrica ni con amputaciones congénitas. Objetivo: determinar la magnitud de inserción laboral de los pacientes con deficiencias congénitas o amputaciones adquiridas antes de los 18 años, que en el año 2013 tengan entre 25 y 65 años, y analizarla según factores demográficos y clínicos. Método: estudio descriptivo que analizó las variables mencionadas mediante una encuesta telefónica diseñada y validada con este objetivo. La población estudiada correspondió a pacientes con amputaciones de Teletón Santiago, actualmente entre 25-65 años de edad, que residieran en la Región Metropolitana durante su período de rehabilitación. Se excluyó a pacientes con amputaciones parciales de mano o pie, y con compromiso cognitivo. Resultados: se incluyeron 61 pacientes. Todos habían trabajado en algún momento de su vida, y un 86,9 por ciento lo hacía al momento de la encuesta. El 67,3 por ciento tuvo acceso a educación superior. El 81,1 por ciento tenía empleo a tiempo completo. Un 22,6 por ciento deseaba realizar alguna modificación al trabajo actual. Sólo se encontró asociación estadísticamente significativa entre edad y el tipo de empleo. Conclusión: la mayoría de los entrevistados tenían empleo y un alto nivel educacional. Estos pacientes se beneficiarían de estrategias sociales de apoyo a nivel nacional.

Background: job reintegration is a major goal in rehabilitation. In amputees it varies from 43-89 percent. Factors related to employment rate are gender, age at the time of amputation, education, prosthetic use, pain, level of amputation and number of limbs compromised. No specific pediatric studies where found. Objective: to measure employment in patients between 25 and 65 years old with limb deficiencies or amputation before the age of 18 years, and describe it according to clinical and demographic factors. Methods: the following descriptive study measured clinical factors, employment status and characteristics of pediatric amputees thought a phone-survey designed and validated for this purpose. Patients were amputees from Teletón Santiago, living in the metropolitan zone during rehabilitation, aged between 25-65 years. Those with partial hand or foot amputations or with cognitive impairment where excluded. Results: sixty-one patients where included. All of them had worked, and 86.9 percent had a job at the time of the survey. 67 percent had access to higher education. Of them, 81.1 percent had a full time job. Only 22.6 percent wanted job adjustments. Differences were only found between age and employment type. Conclusion: the majority of the amputees interviewed were successfully employed and had a high educational level. These patients may benefit from national support strategies.

Repeated Periprosthethic Femoral Fracture in a Below Knee Amputee with Ipsilateral Cementless Total Hip Arthroplasty: A Case Report / 대한고관절학회지

Total hip arthroplasty (THA) is rarely performed in below-knee amputee patients. To the best of the authors' knowledge, periprosthetic femoral fracture in such patients has not been previously reported. Such devastating complication can occur even with minor trauma. To prevent occurrence of such events, there may be several important factors to be considered in performance of THA surgery in below-knee amputee patients and during the course of rehabilitation. In this report, we describe a case involving a below-knee amputee patient who experienced multiple periprosthetic femoral fractures after THA.

Myoelectric Hand Rehabilitation in the Bilateral Upper Extremity Amputee of Burn Patients: Two Cases Report

Bilateral upper extremity amputee is rare and also complex, difficult process to apply the prosthesis to daily life. In Korea, there is no case report of bilateral myoelectric hand training, which is installed to bilateral upper extremity amputee due to electrical burn. We present usual 2 cases, who underwent bilateral transradial amputee, were fitted with a bilateral myoelectric prosthetic hand with an adaptive grip. It's not just long-term issues like the prosthesis prescription, but it is important functional problem whether or not to use actually. Especially the unique features of hand grasp function and writing can be the scale that measure recovery of the patient. The development of modern science and technology applications in clinical medicine cause the innovation of a prosthetic hand. In our two cases, good acceptance and functional improvement were noted. The information obtained in this case would be expected to be helpful in the bilateral amputee prosthetic prescription and training for their welfare.

Myoelectric Prostheses : Current Status and Problems to be Solved, a Rehabilitation Strategy for Higher Level Amputation Patients, and the Future Outlook / The Japanese Journal of Rehabilitation Medicine

Rehabilitation using myoelectric prosthesis for trans-radial amputees has become wide spread and well established in several developed countries. However, the clinical use of myoelectric prostheses for trans-radial amputees has not yet spread in Japan. It is well known that once amputees become accustomed to using their prosthesis efficiently through adequate rehabilitation, that various activities which the amputees had given up so far will become possible through enhanced bimanual activities. Although myoelectric prostheses have proved to be useful, the majority of amputees have not been satisfied with their function. As an amputee becomes a better user, they request not only simple tasks but also complicated ones. As a consequence, the amputee comes to know the limits of their myoelectric prosthesis, thus expectations for superior prostheses will arise. The recent remarkable development of engineering technology has enabled the progress of prosthetic limb technology, leading to the production of far superior functional prostheses which meet the user's expectations. However, there is a paradox in developing such superior prostheses. The more advanced the prosthesis we produce, the higher the cost. To achieve this end, it is absolutely imperative to secure the cooperation of both clinicians and engineers. Furthermore, a rehabilitation strategy for patients with a higher level of amputation(trans-humeral amputation, shoulder disarticulation)remains unsolved. In this paper, we propose a “Hybrid Myoelectric Prosthesis”, which consists of a myoelectric hand as a terminal device and a body-powered active elbow joint, as a realistic solution for higher level amputees. In addition, we introduce Targeted Reinnervation (TR) as a future strategy for reference.

Design of Reciprocal Gait Prosthesis for Bilateral Hip Disarticulation / 中国康复理论与实践

@#ObjectiveTo design a reciprocal gait prosthesis connecting with the other prosthetic accessories for the bilateral hip disarticulation amputees.MethodsThe principle of reciprocal gait orthosis for paraplegia was used in the design, fitting reciprocal gait prosthesis for an amputee, which was compared with an ordinary bilateral Canadian type hip disarticulation prosthesis in the walking velocity and energy expenditure.ResultsThe amputee walked at lower energy expenditure and more like normal gait with reciprocal gait prosthesis while the walking velocity decreased, compared with the conventional prosthesis.ConclusionThis reciprocal gait prosthesis for bilateral hip disarticulation amputee needs less energy expenditure during walking like normal gait.

Application of 3D Gait Analysis in Rehabilitation of Amputees / 中国康复理论与实践

@# The 3D gait analysis system (Vicon) was used for the gait analysis of health persons and amputees who wear lower limb prosthesis. The result indicated that gait analysis can supply changes of kinematics and biomechanics; which can be used to analyze the difference of joint movement between the health persons and amputees. The 3D gait analysis is feasible for amputees in rehabilitation.

El paciente amputado: complicaciones en su proceso de rehabilitación / The amputee patient: complications of its process of rehabilitation

Este artículo se centra en la presentación de las complicaciones que se pueden dar en el muñón de un paciente amputado, teniendo en cuenta las fases y las etapas del proceso de rehabilitación por las cuales debe pasar. Así mismo, el abordaje de este tema se enmarca en una de las principales causas de amputación en el mundo, especialmente en un país como Colombia que desde hace años se encuentra sumergido en una situación especial de violencia. Define, además, diferentes estrategias de intervención para las complicaciones mencionadas y pone en relieve la necesidad de un equipo interdisciplinario de rehabilitación para el tratamiento de las personas con amputación. Concluye con la importancia que tiene la inclusión del paciente en su rol laboral, social y familiar para completar el proceso de rehabilitación.

This article is centered in the presentation of the complications that can be given in the stump of an amputated patient, considering the context of the phases and the stages of the rehabilitation process through which it must pass this type of patient. Also, the boarding of this subject is framed specially in one of the main causes of amputation in the world and in a country like Colombia that for years has been submerged in a special situation of violence. It also defines different strategies from intervention for the mentioned complications and makes it relevant the necessity of a team of rehabilitation for the treatment of these patients, concluding with the importance that has the inclusion of the patient to its occupational, social and familiar roll, to really complete the rehabilitation process. It also defines different strategies from intervention for the mentioned complications and makes it relevant the necessity of an interdisciplinary rehabilitation team for the treatment of these patients. To finish with the part of the process in witch the patient returns back to its working, social and familiar roll.

Rehabilitation of Amputee with Recurrent Squamous Cell Carcinoma Arising from Postburn Scar: A Case Report

A 73-year-old woman who has been suffering from ulcer pain on left lower leg of burn scars visited our clinic for prosthesis rehabilitation. Symptom has been developed since 12 months ago. She burned herself with oil at the age of 40. Biopsy on the skin lesion revealed squamous cell carcinoma. Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Patient had undergone multiple prior split-thickness skin grafts for recurrent squamous cell carcinoma. She had undergone a trans-tibial amputation and subsequently given adjuvant chemotherapy for recurrent disease. After amputee training the patient was able to walk by herself and could perform all activities of daily living independently. Cancer induced amputees need prostheses with intensive rehabilitation training program for ambulation to prevent deterioration of physical function and mental health due to immobilization. However, she developed another recurrence and decided not to undergo further surgery and eventually died in hospice care due to progressive metastatic disease.

Characteristics of Foot Pressure Distribution with or without Partial Prosthetic Foot in Transmetartarsal Amputee / 대한족부족관절학회지

PURPOSE: This study was designed to evaluate characteristics of foot pressure distribution with or without partial prosthetic foot in transmetatarsal amputee. MATERIALS AND METHODS: The subjects were 9 transmetatarsal amputees. Foot pressures were measured at hallux, the 1st-5th metatarsal head (MTH), mid-foot, condyle area by F-scan system in amputated or contralateral foot during active walking. RESULTS: In amputated foot, mean peak pressure was greatest in midfoot without prosthetic foot but it was greatest in hindfoot with prosthetic foot. In unaffected foot, although mean peak pressure was higher in hallux, and 1-5th MTH compared to amputated foot, it was greatest in hind foot both with and without prosthetic foot. However, in unaffected foot, mean peak pressure significantly decreased in hallux and 5th MTH after wearing the prosthetic foot. There was a significant difference in mean peak pressure in hallux and 5th MTH between amputated and unaffected foot after wearing prosthetic foot. However, other region had no significant difference with or without prosthetic foot between feet. CONCLUSIONS: The use of partial prosthetic foot tends to shift weight bearing from the heel area to forefoot and could significantly reduce hind foot peak pressure and redistributed to peak pressure. The partial prosthetic foot can also offer the peak pressure to reduction both amputated foot and unaffected foot and help to toe off during walking.

Free Fillet Flap of the Forearm Amputee for Coverage of the Contralateral below Elbow Amputee and Restoration of the Flexion of the Elbow

Free vascularized tissue transfer to preserve upper extremity amputation level is uncommon but very useful procedure. To cover the below-elbow amputee stump and restore the function of the elbow, we have used a free flap as a spare part concept from the contralateral hand which was so severely damaged that amputation was inevitable.