Stabilizing Transpelvic Prosthetic Socket for a Patient with Spinal Cord Injury Sustaining Right Partial Hemipelvectomy and Left Hip Disarticulation

Abstract

: A bucket-type transpelvic socket was fabricated for a man with paraplegia from spinal cord injury, who underwent right partial pelvic amputation and left hip disarticulation. His main problem was inability to sit due to asymmetrical pelvic shape. We prescribed a transpelvic prosthetic socket to enable him to sit again. The socket consisted of a dual structure: a hard frame and soft liner. The main features of the socket were redistribution of pressure to prevent recurrence of pressure ulcer, and a slightly backward tilt to maintain a comfortable sitting position. In addition, the socket had small air holes for ventilation; a big window in the abdominal area for management of stoma and cystostomy; and two straps for donning it independently. In addition, we confirmed the internal pressure distribution in the socket by a pressure mapping system to prevent reoccurrence of skin trouble. Finally, the patient regained independence in activities of daily living, including driving a car, after two months of rehabilitative training.

Evaluation of disabilities and activities of daily living of war-related bilateral lower extremity amputees

“…Although the stair ascend and descend score had a reverse relationship with amputation level, it was not statistically significant. In a study on war-related hip amputations, the stair domain had the lowest score, 17 and Roehrig et al 24 reported similar low results as well. In another study, Ashraf et al 20 evaluated 335 bilateral lower limb amputees using the Barthel index.…”

“…Other studies done on Iraq–Iran war amputees reported the same age group (range: 18–25 years). 11–14,17–19…”

“…A study performed on war-related hip amputations also expressed the same result. 17 As the level of amputation increases, the IADL index score decreases which will make the amputee more dependent.…”

“…The limitations of our study were that the number of veterans who agreed to participate in our study was only 291 amputees out of a total of 500 possible enrollees, but the number of participants was still more than other similar studies. [6][7][8][9][10][11][12][13][14][15][16][17] Another limitation was that there was no type I or type VII amputation, although we tried to Table 5. ADL score in different bilateral lower limb amputation types (independent amputees were those with a perfect score in each domain).…”