Mobility outcome following unilateral lower limb amputation

Abstract

This study investigated mobility outcome following unilateral trans-tibial or trans-femoral amputation. It was an observational study at the sub-regional amputee rehabilitation centre in Sheffield, UK. All unilateral trans-tibial or transfemoral amputees referred during the study period were included. The Harold Wood Stanmore mobility grade was recorded approximately one year following initial assessment at the centre.Of the 357 amputees referred, complete outcome data was available for 281 (78.7%). The mean age was 68 years (range 16-95), 70.1% were male, and the aetiology of the amputation was vascular or diabetic in 87.5% of cases. Trans-tibial amputations accounted for 50.5% and trans-femoral 49.5%. Almost all trans-tibial and trans-femoral amputees aged 50 and under achieved functional household and community mobility. Approximately 50% of the trans-tibial amputees aged over 50 years gained independent community mobility and around 60% household mobility. There was a significant worsening of community mobility rates with increasing age but for household mobility the differences did not reach statistical significance.Fewer than 25% of trans-femoral amputees aged over 50 achieved community mobility and around 50% achieved household mobility. There was a statistically significant deterioration in both community and household mobility levels with increasing age.

Sand-Casting Technique for Trans-Tibial Prostheses

“…They have no restrictions in mobility, being community ambulators (Davies and Datta 2003). The amputation stumps were in generally good conditions for fitting, with only minor scar formations or bone protrusions and few skin disorders.…”

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

“…The adductor magnus maintains the largest cross sectional area of adductor muscles, thus its moment arm in stabilizing the femur is greatest, making it vital be incorporated in the myodesis. As transfemoral amputees increase in age, they are less likely to ambulate independently [43]. Current belief is that of the two factors, femur length and femur orientation, that length is the dominant factor in assessing gait outcomes for patients with transfemoral amputations.…”

Developing Core Sets for Persons Following Amputation Based on the International Classification of Functioning, Disability and Health as a Way to Specify Functioning

“…Better functional outcomes correlate to a younger age group, better general health in particular cardiovascular health, fewer comorbidities, higher preamputation ambulatory ability, transtibial rather than transfemoral amputation, and an environment which is wheelchair and disability friendly. [10][11][12] The actual functional outcomes of contemporary upper limb prosthetic fitting have not been quantified and this greatly restricts the ability to prognosticate regarding expected vocational outcomes and eventual quality of life. 13 An important basis for the optimal acute and long-term management of amputees is an in-depth understanding of the patient and the functional consequences of the amputation, systematic and detailed consideration of the patient and their environment and sound measurement of functional outcomes for the different sites and levels of amputation.…”