OBJECTIVE: To explore the feasibility of using biomechanical indicators as supplementary evaluation to the Musculoskeletal Tumor Society Scoring System (MSTS) for amputee patients. METHODS: Twenty-four patients who underwent hemipelvectomy between September 2018 and January 2025 were enrolled. There were 15 males and 9 females with an average age of 61.4 years (range, 45-76 years). Participants performed gait tests at self-selected speeds using three assistive devices (prosthesis, single crutch, and double crutches). Motion data were analyzed using a customized OpenSim model. Biomechanical indicators of the intact limb exhibiting common characteristics were screened through correlation and sensitivity analyses. Test-retest reliability [interclass correlation coefficient (ICC)] of selected parameters was assessed to evaluate their potential as MSTS score supplements. RESULTS: All biomechanical indicators showed significant positive correlations with MSTS scores across assistive devices ( P<0.05). Seven indicators demonstrated |Pearson correlation coefficients|>0.8, including walking speed, maximum hip angle, maximum hip moment, peak hip flexion moment, peak hip extension moment, hip flexion impulse, and hip extension impulse. Among these, maximum hip moment, hip flexion impulse, and hip extension impulse exhibited significant between-group differences in adjacent MSTS levels ( P<0.05), indicating high sensitivity, along with excellent test-retest reliability (ICC>0.74, P<0.01). CONCLUSION Biomechanical indicators statistically qualify as potential supplements to MSTS scoring. Maximum hip moment, hip flexion impulse, and hip extension impulse demonstrate particularly high sensitivity to MSTS score variations.
Humans ; Male ; Middle Aged ; Female ; Aged ; Biomechanical Phenomena ; Amputees/rehabilitation* ; Feasibility Studies ; Artificial Limbs ; Reproducibility of Results ; Amputation, Surgical ; Crutches ; Gait

OBJECTIVE: To study factors associated to the quality of life in a North African sample of lower limbs amputees. METHODS: We conducted a prospective study in the Department Physical Medicine and Rehabilitation, University Hospital of Monastit, Tunisia. A consecutive sample of patients with amputations of the lower limbs was included. The evaluated parameters were quality of life using the Short-Form quality-of-life questionnaire (SF-36), pain using a visual analog scale, function using, the perimeter of walking (PW), the Special Interest Group of the Amputee Medicine (SIGAM) and the Locomotion Capacities Index of the Prosthetic Profile of the Amputee (LCI), and psychological status thanks to the Hospital Anxiety and Depression scale. In the study, the patients were evaluated at the first consultation (T0) and again at 12 months (T1). RESULTS: We included 85 patients (age, 59.3±16.7 years) with a sex ratio of 3. The patient quality of life was positively correlated to distal type of amputation, traumatic origin, better LCI (p≤0.001, r=0.349), SIGAM (p=0.046) and PW. A negative correlation was noted with age (p=0.012, r=−0.483) and higher psychological scores (p=0.002, r=−0.321). CONCLUSION: In our sample of North African lower limbs amputees the age and the functional status were the most important predictors of the quality of life.
Amputation ; Amputation, Traumatic ; Amputees ; Anxiety ; Depression ; Humans ; Locomotion ; Lower Extremity ; Physical and Rehabilitation Medicine ; Prospective Studies ; Prostheses and Implants ; Public Opinion ; Quality of Life ; Sex Ratio ; Tunisia ; Visual Analog Scale ; Walking

To find a multiple amputee more severe than a triple amputee is not easy. This is a report of a 36-year-old patient with right knee disarticulation, left trans-femoral amputation and right elbow disarticulation due to peripheral ischemic necrosis, when he was applied vasopressor in septic shock condition. His left hand was also 2nd, 3rd, 4th, and 5th distal interphalangeal joint disarticulation status, and it was more difficult for him to do rehabilitation program, such as donning and doffing the prostheses. For more efficient rehabilitation training program, we first focused on upper extremities function, since we believed that he might need a walking aid for gait training later. After 13 weeks of rehabilitation program, he has become sit to stand and walk short distance independently with an anterior walker. Although he still needs some assistance with activities of daily living, his Functional Independence Measure score improved from 48 to 90 during the course of 13 weeks.
Activities of Daily Living ; Adult ; Amputation ; Amputees* ; Disarticulation ; Education ; Elbow ; Extremities* ; Gait ; Hand ; Humans ; Joints ; Knee ; Necrosis ; Prostheses and Implants ; Rehabilitation* ; Shock, Septic ; Upper Extremity ; Walkers ; Walking

The functional independence of persons with disabilities will be achieved through provisions of affordable, appropriate and accessible prosthetic devices. The Physicians for Peace "Walking Free" Program, through the Departments of Rehabilitation Medicine and Orthopedics, Philippine General Hospital, rose up to the six challenges of ensuring sustainable delivery of high technology, low cost prostheses to indigent Filipino amputees that not only provide community reintegration but economic empowerment as well.

Amputees ; Disabled Persons ; Hospitals, General ; Orthopedic Procedures ; Orthopedics ; Philippines ; Physical And Rehabilitation Medicine ; Poverty ; Prostheses And Implants ; Walking

Triple amputee is an uncommon impairment and has been rarely reported. We reported a case of success in independent bipedal ambulation of a triple amputee with bilateral lower limb prostheses. We selected a thirty five-year-old male who underwent a left shoulder disarticulation and a left very short transfemoral amputation and a right transfemoral amputation due to trauma. After program of gait training for eight weeks, he could walk independently, donning right hip disarticulation prosthesis and left transfemoral prosthesis and left shoulder disarticulation prosthesis with right Lofstrand forearm orthosis. We measured the amountof oxygen consumption of the patient before and after rehabilitation program done, of which all parameters including oxygen consumption were more improved than before that program. The patient preferred to walk by himself and got a feeling of full achievement. Nevertheless higher energy consumption, young active triple amputees need fitting prostheses with intensive rehabilitation training program for bipedal ambulation to prevent deterioration of physical function and mental health due to immobilization.
Amputation ; Amputees* ; Disarticulation ; Education ; Forearm ; Gait ; Hip ; Humans ; Immobilization ; Lower Extremity ; Male ; Mental Health ; Orthotic Devices ; Oxygen Consumption ; Prostheses and Implants ; Rehabilitation* ; Shoulder ; Walking*

Monolimb is a new type of lower-limb prostheses made of macromolecule polymer, in which the socket and prosthetic shank are integrative. Compared with traditional prosthesis, monolimb is more economical, good-looking and portable, so it indicates a possible direction in the future. Biomechanical research on trans-tibial monolimb is necessary and helpful just like traditional prosthesis. In this article, a 3D FE model based on real geometry shape of an endoskeletal trans-tibial monolimb is established. Keeping the same geometrical shape, three 3D FE models of transtibial monolimbs with different wall thickness are established. The influence of wall thickness on the stress distribution is analyzed under the load corresponding to the subphase of stance of Heel Off. The results indicate that stress within transtibial monolimb and pressure on the surface of soft tissue could be decreased with wall thickness of transtibial monolimb increased. This study will be helpful for the standard of wall thickness in designing transtibial monolimb.
Amputees ; rehabilitation ; Artificial Limbs ; Biomechanical Phenomena ; Humans ; Leg ; surgery ; Prosthesis Design ; Stress, Mechanical

BACKGROUND: There has been no clinical study of skin problems of the amputee in Korea and at Veterans Hospital, we have experienced so many skin problems of amputees. OBJECTIVE: We tried to observe skin problems of amputees and to relate them with sweating, poor hygiene, poor fit of socket, mechanical trauma, and duration of wearing prosthesis. METHODS: 125 extremity amputees who visited the Seoul Veterans Hospital during the period of 5 years from Jan. 1994 to Dec. 1998 were analyzed clinically. RESULTS: The study results are summarized as follows: 1. Among the 125 extremity amputees, the number of male patients was 124(99.2%) and that of female patients was 1(0.8%). The age distribution showed a peak incidence in the 7th decade(30.4%), followed by the 5th decade(28.8%), 6th decade(24.8%), and the mean age was 56.4 years. 2. The most common type of amputation was below the knee amputation(74 cases), the second was above the knee amputation(37 cases). 3. The duration of wearing prosthesis was above 20 years in 88 patients(70.4%), 16-20 years in 15(12%), 11-15 years in 11(8.8%), and 1-5 years in 6(4.8%). 4. The skin problems of the amputees were superficial fungal infection, chronic ulcer, intertriginous dermatitis, callus, corn, verrucous hyperplasia, verruca which were 63 cases(50.4%), 26 cases(20.80%), 17 cases(13.6%), 6 cases(4.8%), 5 cases(4%), 5 cases(4%), 3 cases(2.4%) respectively. 5. The predisposing factors of the dermatoses were mechanical trauma(84 cases) which acted as a cause of the chronic ulcer, intertriginous dermatitis, corn and callus, sweating(80 cases) and poor hygiene(11 cases) as those of superficial fungal infection, and poor fitting(6 cases) as that of verrucous hyperplasia. CONCLUSION: Superficial fungal infection and chronic ulcer were the main skin problems of the amputee. The longer the duration of wearing prosthesis, the more skin problems developed. The mechanical trauma and sweating were the major predisposing factors of stump dermatoses, especially of chronic ulcer and superficial fungal infection. Amputation is only the beginning of a long period of rehabilitation, and the treatment of the patient and the affected skin goes on for the rest of the patient's life. This clinical study suggests that the dermatologist must be concerned of the care of amputee's skin problems.
Age Distribution ; Amputation ; Amputees* ; Bony Callus ; Causality ; Dermatitis ; Extremities ; Female ; Hospitals, Veterans ; Humans ; Hygiene ; Hyperplasia ; Incidence ; Knee ; Korea ; Male ; Prostheses and Implants ; Rehabilitation ; Seoul ; Skin Diseases ; Skin* ; Sweat ; Sweating ; Ulcer ; Warts ; Zea mays

Rehabilitation in patients with bilateral upper extremity amputation presents a considerable problem for prosthetic training. This is a report of a bilateral transhumeral amputee and a bilateral transradial amputee admitted for intensive prosthetic rehabilitation. They underwent bilateral upper extremity amputation due to electric burn. They were successfully fitted with conventional body-powered prostheses. The problems in rehabilitation of adult bilateral upper extremity amputees were discussed and the patients' compliance was assessed. In our two cases, good acceptance and functional benefit were noted. Thus, we suggest that multidisciplinary approach including prosthetists with full discussion should be a very important factor for specialized comprehensive prosthetic training of multiple complexed amputee.
Adult ; Amputation ; Amputees* ; Burns, Electric ; Compliance ; Humans ; Prostheses and Implants ; Rehabilitation* ; Upper Extremity*

Chronic dermatological problems associated with lower limb amputation sites include local maceration, intertrigo, blistering and ulceration, contact dermatitis, tissue atrophy, verrucous hyperplasia, lichenification, callosities, epidermoid cyst formation, and malignant neoplasia. A 60 year-old male was presented with a verrucous oozing eruption of the amputation stump of the left leg. He had been involved in a railroad logging accident 30 years before, resulting in the loss of the left lower limb. He were a below-knee prosthesis (patellar-tendon hearing). We diagnosed him as verrucous hyperplasia by clinical and histological findings and then referred him to the division of rehabilitation for a refitting of his prosthesis, after which his eruption cleared two months later.
Amputation ; Amputation Stumps ; Amputees* ; Atrophy ; Blister ; Callosities ; Dermatitis, Contact ; Epidermal Cyst ; Humans ; Hyperplasia* ; Intertrigo ; Leg ; Lower Extremity ; Male ; Middle Aged ; Prostheses and Implants ; Railroads ; Rehabilitation ; Ulcer

OBJECTIVE: To evaluate the clinical features of lower extremity amputees and the process of prosthetic fitting and its use at follow up and to know the effects of prosthetic rehabilitation on adaptation to prosthesis and its long-term use. METHOD: One hundred and twenty four patients who underwent amputation surgery in 3 major hospitals in Korea from 1990 to 1997 were enrolled. They were evaluated by reviewing of medical records for anthropometry, level of amputation, causes of amputation, other coincidental medical problems, general physical states and followed up by telephone and mail questionnaire with respect to general outcome, prosthetic fitting, satisfaction of prosthesis, state of prosthetic use, functional state of prosthetic ambulation. RESULTS: The most common cause of amputation was trauma. The mean time to fit the prosthesis was 4.1 months and only 38 patients was supervised by rehabilitation programs. The patients who were supervised by rehabilitation program were fitted and able to ambulate significantly earlier than those who were not. They wore and used prosthesis significantly more often than those who were not supervised. The patients with above knee amputation who were supervised were significantly independent with walking aids. CONCLUSION: Rehabilitation training program enables amtupees to be fitted and walk earlier with prosthesis. Also, this program lowered the dependency on walking aids in above knee amputees.
Amputation ; Amputees* ; Anthropometry ; Education ; Follow-Up Studies* ; Humans ; Knee ; Korea ; Lower Extremity* ; Medical Records ; Postal Service ; Prostheses and Implants ; Surveys and Questionnaires* ; Rehabilitation ; Telephone ; Walking