Development of a prosthetic fit and alignment assessment (ProFit) in persons with post-traumatic transtibial amputation
Abstract:Background:There are no standards for reliably measuring the quality of prosthetic fit and alignment which is important for evaluation and improvement of clinical care for patients with transtibial amputation.Objectives:The purpose of this study was to develop an instrument to quantitatively assess prosthetic fit and alignment in patients with transtibial amputation.Study Design:Prospective cohort study.Methods:The fit and alignment assessment (ProFit) included 39 items for assessments of skin quality, stance … Show more
“… 29 , 30 Prosthetic fit and limb alignment have been identified as important factors affecting patient satisfaction with traditional prosthetics. 31 , 32 The extensive variability in injury characteristics, including the length of the residual limb, soft tissue integrity, preservation of nerve function, and patient habitus can leave some patients dealing with poor prosthetic fit leading to chronic wounds, increased energy expenditure, and overall dissatisfaction with traditional lower limb prosthetics.…”
Section: Postoperative Care and Prostheticsmentioning
Mangled extremities are a challenging problem for the orthopaedic surgeon. The decision for salvage versus amputation is multifactorial. Several work groups have attempted to create scoring systems to guide treatment, but each case must be regarded individually. As surgical technique and prosthetics continue to improve, amputations should be seen as a viable reconstructive option, rather than failure. This article reviews scoring systems for the mangled extremity, outcomes on salvage versus amputation, amputation surgical technique, and prosthetic options.
“… 29 , 30 Prosthetic fit and limb alignment have been identified as important factors affecting patient satisfaction with traditional prosthetics. 31 , 32 The extensive variability in injury characteristics, including the length of the residual limb, soft tissue integrity, preservation of nerve function, and patient habitus can leave some patients dealing with poor prosthetic fit leading to chronic wounds, increased energy expenditure, and overall dissatisfaction with traditional lower limb prosthetics.…”
Section: Postoperative Care and Prostheticsmentioning
Mangled extremities are a challenging problem for the orthopaedic surgeon. The decision for salvage versus amputation is multifactorial. Several work groups have attempted to create scoring systems to guide treatment, but each case must be regarded individually. As surgical technique and prosthetics continue to improve, amputations should be seen as a viable reconstructive option, rather than failure. This article reviews scoring systems for the mangled extremity, outcomes on salvage versus amputation, amputation surgical technique, and prosthetic options.
“…To address this gap, METRC developed a project to design and validate an instrument to quantitatively assess the quality of the socket fit and alignment process. 28 The study enrolled 117 amputee patients, many from the TAOS study (above), who were evaluated by an expert orthotic/prosthetic panel based on photographs, radiographs, videos, and data from validated performance tests and patient-reported outcome measures to develop a patient-specific ProFit score. This information will be important in future studies of amputee populations, with and without limb salvage as a comparison group, as it will provide a means to adjust reported amputation outcomes as affected by suboptimal prosthetic fit and alignment.…”
The Major Extremity Trauma Research Consortium (METRC) is a unique and ongoing military-civilian collaboration that resulted in the largest orthopaedic trauma research enterprise to date. The Consortium was established in September 2009 with funding from the Department of Defense. It employs a centralized data coordinating center and has grown into a network of nearly 400 investigators at 70 clinical centers. METRC conducts large multicenter clinical research studies selected and designed to improve outcomes among severely injured military and civilian patients with extremity trauma. Over the past decade, the consortium has implemented 35 such studies distributed among 19 principal investigators, enrolled more than 23,000 patients, published 61 articles, and received more than $150 million in funding from the Department of Defense, Patient Centered Outcomes Research Institute, and National Institutes of Health. This unique multidisciplinary research platform is a powerful community capable of addressing the challenging issues related to the evaluation, treatment, and recovery after severe extremity trauma. This body of work received the 2023 Elizabeth Winston Lanier Kappa Delta Award. An overview of the METRC development, organization, and research focus areas is presented.
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