No abstract

Background: It is difficult for the lower limb amputee patients to adapt to their new lifestyles. Objective: To compare the life quality and functionality of patients with bilateral vs. unilateral lower extremity amputations. Study Design: Cross-sectional study. Methods: Fifteen bilateral and 15 unilateral lower extremity amputee patients were enrolled. Demographics, cause and level of amputations, frequency and duration of prosthesis use were evaluated. SF-36, Satisfaction with Prosthesis Questionnaire (SAT-PRO), Amputee Body Image Scale. (ABIS), Houghton Scale (HS), six-minute walk test (6MWT), and 10-metre walk test (10 MWT) were performed. Results: Physical function, physical and emotional role scores of SF-36 were significantly lower in the bilateral amputee group in comparison with the unilateral group. SAT-PRO and ABIS total scores were similar between the groups. There was a positive correlation between the frequency of prosthetic use and SF-36 subgroups (except pain). The unilateral amputee group had significantly better scores than the bilateral amputee group in terms of HS, 6MWT and 10 MWT. Conclusion: Physical capacity of bilateral lower extremity amputee patients is lower than the unilateral amputee patients; satisfaction with prosthesis and body image are not related with the amputation level; and the life quality and satisfaction with prostheses are increased in parallel with the use of the prostheses. Clinical relevanceAlthough differences exist between the groups, in terms of quality of life and functionality, patients can reach an acceptable life standard with good rehabilitation and a suitable prosthesis.

Amputee patients spend more energy during walking than able-bodied persons. It is generally accepted that more proximal amputation is associated with more energy need. However, the picture is not clear, especially for partial foot amputees. The purpose of this study was to compare the energy consumption of walking in traumatic unilateral amputees with three different amputation levels (transfemoral, trans-tibial and partial foot amputations). Sixty-four male unilateral traumatic amputees participated in this study. Energy expenditure during walking was measured for four different speed and slope combinations: 1.5 km/h and 08 slope, 3 km/h and 08 slope, 1.5 km/h and 58 slope, 3 km/h and 58 slope. Mean O 2 consumption (ml/kg/min) of the last 2 min of each 5-min session was calculated. In all four combinations, energy expenditure of trans-tibial amputees was the lowest, and energy expenditure of trans-femoral amputees was the highest. Statistical significance, however, could not be obtained for the differences among the groups. In conclusion, walking of partial foot amputees does not seem to be more energy efficient than that of higher level amputees.

This article reports an analysis of 75 consecutive lower limb amputees who developed painful neuroma requiring surgical excision after lower limb amputation following landmine explosions. This retrospective study analyses the results of 75 patients who were treated for painful neuroma after lower limb amputation following landmine explosions between the years 2000 and 2006. The average time period from use of prosthesis to start of symptoms suggesting neuroma was 9.6 months. The average time period from start of pain symptoms to neuroma surgery was 7.8 months. All clinically proven neuromas were surgically resected. In the mean follow-up of 2.8 years, all patients were satisfied with the end results and all were free of any pain symptoms. Painful stump with clinical diagnostic findings of neuroma described above may be regarded as neuroma without requiring any further imaging modalities and is an indication for surgery if conservative measures fail.

The aims of this study were to: (i) Determine if there were significant bone mineral density and muscle strength differences between intact and amputated limbs, and (ii) investigate the possible relationship between local bone loss and muscle strength in transtibial amputees. Fifteen male veterans with traumatic unilateral transtibial amputations who ranged in age from 18-45 years were included in this prospective study. Lower limb muscle strength was measured with an isokinetic dynamometer. Dual energy X-ray absorptiometry was used to determine bone mineral density of the femur and tibia. The bone mineral density values of the femur and tibia were found significantly decreased on the amputated side. Significant decreases (p < 0.001) in strength of the quadriceps and hamstrings were observed in the amputated limb. There was a weak correlation between quadriceps strength and total femur bone mineral density (p = 0.048, r = 0.518) on the amputated limb. Transtibial amputees are prone to bone mineral loss and muscle strength decrease on the amputated side. Our results also indicate that muscle strength itself might not be of decisive importance for bone mass in transtibial amputees.