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prosthetic limbs

Vivek S Chawathe, Anil K Gaur, Badrinath D Athani, Shefali Gupta
A 14-year-old boy reported with congenital deformity of the left lower limb, with gross shortening, hip and knee flexion deformities, ankle with equinus deformity, and polydactyly of the left foot. Radiologic examination showed proximal femoral focal deficiency, double fibula, and duplication of the tarsal bones, and a diagnosis of 'proximal femoral focal deficiency associated with fibular duplication and diplopodia with complete agenesis of tibia' was made. Such association of deformities is very rare and poses difficulties in rehabilitation of the case...
October 25, 2016: Journal of Pediatric Orthopedics. Part B
Luke Osborn, Rahul Kaliki, Alcimar Soares, Nitish Thakor
Upper limb amputees lack the valuable tactile sensing that helps provide context about the surrounding environment. Here we utilize tactile information to provide active touch feedback to a prosthetic hand. First, we developed fingertip tactile sensors for producing biomimetic spiking responses for monitoring contact, release, and slip of an object grasped by a prosthetic hand. We convert the sensor output into pulses, mimicking the rapid and slowly adapting spiking responses of receptor afferents found in the human body...
April 2016: IEEE Transactions on Haptics
Matthijs H Spaan, Aline H Vrieling, Pim van de Berg, Pieter U Dijkstra, Helco G van Keeken
STUDY DESIGN: Retrospective cohort study. BACKGROUND: Persons with a lower limb amputation can regain mobility using a prosthetic device. For fast and adequate prescription of prosthetic components, it is necessary to predict the mobility outcome early in rehabilitation. Currently, prosthetic prescription is primarily based on empirical knowledge of rehabilitation professionals. OBJECTIVE: In this study, we explored motor ability tests, to be completed without a prosthetic device, which have predictive value for mobility outcome at the end of rehabilitation...
October 20, 2016: Prosthetics and Orthotics International
Sook-Yee Chong, Oliver Röhrle
A satisfactorily fitted socket interacts dynamically with the stump in order to support body weight, transmit load effectively, enhance dynamic stability, and enable the control and stabilization of the residual limb. The internal dynamics occurring within a socket is important in determining optimal fit. Many measurement and imaging techniques, such as X-rays, have been utilized to investigate the movement of the residual femur within the stump during gait. However, due to associated health risks and costs, none of the current techniques have been extended to clinical prosthetics...
2016: PloS One
Eric Klingelhoefer, Hendrik Bergert, Stephan Kersting, Stefan Ludwig, Norbert Weiss, Frank Schönleben, Robert Grützmann, Gabor Gäbel
BACKGROUND: Peripheral arterial disease (PAD) is one of the most underestimated diseases because of its high prevalence and unfavorable prognosis. Many PAD patients without suitable autologous veins or options for endovascular treatment receive prosthetic above-knee femoropopliteal bypass (PAKB). Until now predictors of prosthetic bypass failure and of increased amputation risk remain indistinct. This study aimed to identify predictive factors associated with better bypass patency and limb salvage to achieve a more favorable outcome after PAKB reconstruction...
August 2016: Journal of Vascular Surgery
Valerie E Kelly, Sara J Morgan, Dagmar Amtmann, Rana Salem, Brian J Hafner
PURPOSE: This study tested the hypothesis that greater perceived cognitive concerns are associated with worse mobility in a cohort of prosthesis users with lower limb loss (LLL). METHOD: We performed a secondary analysis of cross-sectional self-report data from a volunteer sample of people with LLL due to dysvascular and non-dysvacular causes. Perceived cognitive difficulties were assessed using the Quality of Life in Neurological Disorders Applied Cognition - General Concerns (Neuro-QoL ACGC)...
October 19, 2016: Disability and Rehabilitation
Robert D Gregg, Anne E Martin
Recent work has extended the control method of virtual constraints, originally developed for autonomous walking robots, to powered prosthetic legs for lower-limb amputees. Virtual constraints define desired joint patterns as functions of a mechanical phasing variable, which are typically enforced by torque control laws that linearize the output dynamics associated with the virtual constraints. However, the output dynamics of a powered prosthetic leg generally depend on the human interaction forces, which must be measured and canceled by the feedback linearizing control law...
July 2016: Proceedings of the ... American Control Conference
Sara J Morgan, Janna L Friedly, Dagmar Amtmann, Rana Salem, Brian J Hafner
OBJECTIVE: To determine relationships between pain site(s) and pain intensity/interference in people with lower limb amputations. DESIGN: Cross-sectional survey. SETTING: Community. PARTICIPANTS: Lower limb prosthesis users with unilateral or bilateral amputations (n=1296, mean time since amputation = 14.1 years). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity (1-item to assess average pain), PROMIS Pain Interference (4-item short form to assess the consequences of pain in desired activities), and questions that asked participants to rate the extent to which each of the following were a problem: residual limb pain, phantom limb pain, knee pain on the non-amputated side, back pain, and shoulder pain...
October 11, 2016: Archives of Physical Medicine and Rehabilitation
Oskar C Aszmann, Ivan Vujaklija, Aidan D Roche, Stefan Salminger, Malvina Herceg, Agnes Sturma, Laura A Hruby, Anna Pittermann, Christian Hofer, Sebastian Amsuess, Dario Farina
Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries...
October 10, 2016: Scientific Reports
Oliver Gale-Grant, Eric S Chemla
OBJECTIVE: Prosthetic infraclavicular axillary-axillary arteriovenous access grafts are one of a number of complex dialysis access options in patients when all of the usual upper limb possibilities have been exhausted. We present a follow-up of 35 patients who received this access graft during a 9-year period. METHODS: Patients were identified from our own operation records. Follow-up data were gathered from their locally held electronic medical records. Primary and secondary patency were calculated using the Kaplan-Meier estimate...
October 1, 2016: Journal of Vascular Surgery
Raju Vaishya, Vipul Vijay, Ram Sagar Pandit, Amit K Agarwal
INTRODUCTION: Fractures of the distal humerus are a rare entity accounting for approximately 2% of the humeral fractures. Non union of the distal humerus is further rare and poses a major challenge. These fractures usually respond to open reduction and bone grafting but some may fail multiple surgical attempts at union and hence are labelled as "resistant" non union. We report a case of resistant non union of the distal humerus which was managed by total elbow arthroplasty. CASE PRESENTATION: A 49-year-old male presented to the out patient department with history of a compound comminuted fracture of the distal end of the humerus approximately 25 years back...
April 2016: Journal of Orthopaedic Case Reports
Neha Mathur, Ivan Glesk, Arjan Buis
Elevated skin temperature at the body/device interface of lower-limb prostheses is one of the major factors that affect tissue health. The heat dissipation in prosthetic sockets is greatly influenced by the thermal conductive properties of the hard socket and liner material employed. However, monitoring of the interface temperature at skin level in lower-limb prosthesis is notoriously complicated. This is due to the flexible nature of the interface liners used which requires consistent positioning of sensors during donning and doffing...
June 2016: Healthcare Technology Letters
Fan Tang, Yong Zhou, Li Min, Wenli Zhang, Rui Shi, Yi Luo, Hong Duan, Chongqi Tu
OBJECTIVE: To evaluate the medium-term outcome of limb-salvage surgery using all-polyethylene tibial endoprosthetic replacement following en-block resection for distal femoral tumors. METHODS: Forty-nine patients with distal femoral tumor were treated between June 2006 and June 2012. The follow-up period was 6-110 months (average 53.4 months). The prosthetic survival was analyzed using the Kaplan-Meier method. The classification of failure of limb salvage after reconstructive surgery for bone tumors was adapted...
2016: OncoTargets and Therapy
Peter A Soden, Sara L Zettervall, Thomas Curran, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
OBJECTIVE: Prior studies on the cause and effect of surgical variation have been limited by utilization of administrative data. The Vascular Quality Initiative (VQI), a robust national clinical registry, provides anatomic and perioperative details allowing a more robust analysis of variation in surgical practice. METHODS: The VQI was used to identify all patients undergoing infrainguinal open bypass or endovascular intervention from 2009 to 2014. Asymptomatic patients were excluded...
September 27, 2016: Journal of Vascular Surgery
Iván De-Rosende Celeiro, Luisa Simón Sanjuán, Sergio Santos-Del-Riego
PURPOSE: The main objective was to assess the change in the functional independence in basic activities of daily living (ADL) following a pre-prosthetic intervention in people with lower-limb amputation (LLA). Secondary objectives were to identify the factors contributing to the success of this intervention, and to analyze the effects on the presence of unmet needs for home adaptation. METHOD: The ADL intervention was early and pre-prosthetic; it was focused on six self-care activities...
August 16, 2016: Disability and Rehabilitation
Aurelie Vouilloz, François Luthi
OBJECTIVE: A lower limb amputation is a major event for a patient with many questions arising for him and his family. Individual and environmental factors could influence patient's quality of life and adaptation to amputation. Most of the time brochures concern post operative care after limb amputation (surgery type, stump medical care, prosthetics…). Rehabilitation is often only briefly dealt with these brochures. OBJECTIVES OF THIS STUDY: (1) To write a brochure specifically concerning rehabilitation for lower limb amputees...
September 2016: Annals of Physical and Rehabilitation Medicine
Thibaut Mirlicourtois, Tche Hong Loquineau, Pierre Yves Chagnon, Thomas Rondepierre, Serge Mirlicourtois, Jean Christophe Bonnardel
OBJECTIVE: The replacement of a mechanical knee with prosthetic class I foot fitting by an electronic knee with prosthetic class II foot was proposed to a 54-years-old schizophrenic patient, active, with right femoral and left tibial traumatic amputation. This fitting evolution was assessed both quantitatively and qualitatively. OBSERVATIONS/METHOD: Compared evaluation of electronic knee with prosthetic class II foot versus mechanical polycentric knee with prosthetic class I foot (fitting unchanged moreover) in: - functional abilities and quality of life using standardized scores (Functional Ambulation Classification, Houghton, Functional Independence Measurement, B...
September 2016: Annals of Physical and Rehabilitation Medicine
Chloé Blum, Solange Ehrler, Marie-Eve Isner
OBJECTIVE: Therapeutic patient education (TPE) is a continuous process for chronic disease. TPE enables patients to improve and acquire the skills that are necessary for self-care and self-management. We wanted to determine the place of self-care in patients following lower limb amputation by evaluating prosthetic and limb management and prosthesis use. MATERIAL/PATIENTS AND METHODS: To this aim, we involved 135 trans-tibial amputees between May 2011 and December 2013 who were fitted with contact silicone socket prosthesis with distal lock...
September 2016: Annals of Physical and Rehabilitation Medicine
Jacques Griffet
Amputation of a limb is always perceived as a catastrophe. The principles underlying creation of a stump adapted to modern prosthetic fittings must be fully understood and the patient managed by a multidisciplinary team. In paediatric patients, preserving residual limb length is a crucial point that should be assessed according to the expected growth potential. Advances in prosthetic fittings have led to changes in the overall concept of socket design, which seeks to achieve three objectives: to maximise the weight-bearing surface area, to eliminate friction of the skin on the socket, and to eliminate lever-arm effects...
September 2016: Annals of Physical and Rehabilitation Medicine
Nathaly Quintero-Prigent, Caroline Radot, Marion Fiat, Malak Fahny, Naima Brennetot
OBJECTIVE: Fibular hemimelia or longitudinal fibular deficiency is the most frequent congenital malformation of lower limbs. It causes sometimes major limbs shortening. Different treatments could be considered depending on the severity of the malformation: contralateral epiphysiodesis, corrective foot and knee osteotomies, leg-lengthening surgery with external fixation, prosthesis. For the most severe cases (15-20cm bone length discrepancies or unstable knee or foot), leg-lengthening surgery with external fixation is not recommended...
September 2016: Annals of Physical and Rehabilitation Medicine
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