As an important auxiliary tool for amputees to gain abled limb functions, prosthetic limbs with decoration or feedforward control channel could not meet the needs. In order to enable the prosthesis to deliver the information, includes temperature, pressure, position, shape and so on, a variety of sensory feedback methods have been integrated into the prosthesis. According to the position of the feedback terminal on the human body, the perceptual feedback systems include invasive and noninvasive sensory feedback. This review presents the research progress of these perceptual feedback techniques, and summarizes the problems in the application in artificial limbs. Finally, the development trend of sensory feedback technology in prostheses is prospected.
Amputees ; Artificial Limbs ; Feedback, Sensory ; Humans ; Prosthesis Design ; Technology

Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.
Amputees ; Femoral Neck Fractures/surgery* ; Femur ; Fracture Fixation, Internal ; Humans ; Lower Extremity

Amputees ; Deltoid Muscle/surgery* ; Humans ; Muscle, Skeletal ; Nerve Transfer ; Quality Control ; Upper Extremity/surgery*

INTRODUCTION: Amputation is often associated with depression, isolation and anxiety, resulting in changes
in the functioning and quality of life of an individual. This study aimed to compare the quality of life of
amputees before and after prosthetic rehabilitation and to determine the level of satisfaction with the
services provided by the rehabilitation team.

METHODS: This was a longitudinal study conducted at the Philippine School of Prosthetics and Orthotics
from 2016 to 2017. Quality of life was measured at baseline and at the end of prosthetic rehabilitation
using the Short Form-36 version 2 Philippines (Tagalog) and compared. Patient satisfaction was determined
using the UERMMMCI Out-Patient Satisfaction Survey. Statistical analysis was done using paired t-test
and stratified analysis.

RESULTS: Twelve participants were included; majority were adult males and all were unemployed. There
were no statistically significant changes in the quality of life of amputees after prosthetic rehabilitation.
Stratification analysis revealed significant decreases in scores in bodily pain and general health scales for
females. On the other hand, males had statistically significant increases in vitality scores. Participants
were generally satisfied with the services they received.

CONCLUSION: While no significant changes were observed for overall quality of life, certain aspects may be
related to factors such as sex, comorbidities, and type of caregiver. Recommendations include further studies
to explore other factors affecting quality of life among Filipino amputees after prosthetic rehabilitation.

Myoelectric prosthesis requires a sensor that can reliably capture surface electromyography (sEMG) signal from amputees for its controlled operation. The main problems with the presently available EMG devices are their extremely high cost, large response time, noise susceptibility, less amplitude sensitivity, and larger size. This paper proposes a compact and affordable EMG sensor for the prosthetic application. The sensor consists of an electrode interface, signal conditioning unit, and power supply unit all encased in a single package. The performance of dry electrodes employed in the skin interface was compared with the conventional Ag/AgCl electrodes, and the results were found satisfactory. The envelope detection technique in the sensor based on the tuned RC parameters enables the generation of smooth, faster, and repeatable EMG envelope irrespective of signal strength and subject variability. The output performance of the developed sensor was compared with commercial EMG sensor regarding signal-to-noise ratio, sensitivity, and response time. To perform this, EMG data with both devices were recorded for 10 subjects (3 amputees and 7 healthy subjects). The results showed 1.4 times greater SNR values and 45% higher sensitivity of the developed sensor than the commercial EMG sensor. Also, the proposed sensor was 57% faster than the commercial sensor in producing the output response. The sEMG sensor was further tested on amputees to control the operation of a self-designed 3D printed prosthetic hand. With proportional control scheme, the myoelectric hand setup was able to provide quicker and delicate grasping of objects as per the strength of the EMG signal.
Amputees ; Electric Power Supplies ; Electrodes ; Electromyography ; Hand Strength ; Hand ; Humans ; Noise ; Prostheses and Implants ; Reaction Time ; Signal-To-Noise Ratio ; Skin

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

BACKGROUND: Prosthetic hands with a myoelectric interface have recently received interest within the broader category of hand prostheses, but their high cost is a major barrier to use. Modern three-dimensional (3D) printing technology has enabled more widespread development and cost-effectiveness in the field of prostheses. The objective of the present study was to evaluate the clinical impact of a low-cost 3D-printed myoelectric-interface prosthetic hand on patients' daily life. METHODS: A prospective review of all upper-arm transradial amputation amputees who used 3D-printed myoelectric interface prostheses (Mark V) between January 2016 and August 2017 was conducted. The functional outcomes of prosthesis usage over a 3-month follow-up period were measured using a validated method (Orthotics Prosthetics User Survey–Upper Extremity Functional Status [OPUS-UEFS]). In addition, the correlation between the length of the amputated radius and changes in OPUS-UEFS scores was analyzed. RESULTS: Ten patients were included in the study. After use of the 3D-printed myoelectric single electromyography channel prosthesis for 3 months, the average OPUS-UEFS score significantly increased from 45.50 to 60.10. The Spearman correlation coefficient (r) of the correlation between radius length and OPUS-UEFS at the 3rd month of prosthetic use was 0.815. CONCLUSIONS: This low-cost 3D-printed myoelectric-interface prosthetic hand with a single reliable myoelectrical signal shows the potential to positively impact amputees' quality of life through daily usage. The emergence of a low-cost 3D-printed myoelectric prosthesis could lead to new market trends, with such a device gaining popularity via reduced production costs and increased market demand.
Amputation ; Amputation Stumps ; Amputees ; Artificial Limbs ; Electromyography ; Extremities ; Follow-Up Studies ; Hand ; Humans ; Methods ; Prospective Studies ; Prostheses and Implants ; Quality of Life ; Radius

Artificial prosthesis is an important tool to help amputees to gain or partially obtain abled human limb functions. Compared with traditional prosthesis which is only for decoration or merely has feedforward control channel, the perception and feedback function of prosthesis is an important guarantee for its normal use and self-safety. And this includes the information of position, force, texture, roughness, temperature and so on. This paper mainly summarizes the development and current status of artificial prostheses in the field of perception and feedback technology in recent years, which is derived from two aspects: the recognition way of perception signals and the feedback way of perception signals. Among the part of recognition way of perception signals, the current commonly adopted sensors related to perception information acquisition and their application status in prosthesis are overviewed. Additionally, from the aspects of force feedback stimulation, invasive/non-invasive electrical stimulation, and vibration stimulation, the feedback methods of perception signals are summarized and analyzed. Finally, some problems existing in the perception and feedback technology of artificial prosthesis are proposed, and their development trends are also prospected.
Amputees ; Artificial Limbs ; Feedback, Sensory ; Humans ; Prosthesis Design ; Prosthesis Implantation

Replantation using microvascular anastomosis is considered to be the optimal method in treating the amputated ear in terms of resulting color, texture, and shape. Only a few cases of ear replantation have been reported because it is anatomically difficult to identify suitable vessels for anastomosis. We successfully replanted the amputated helical rim of the ear using single arterial anastomosis. A 37-year-old man had his helical rim amputated by a human bite. The amputee was about 4 × 1 cm in dimension, composed of skin and soft tissue including auricular cartilage. Replantation was performed anastomosing a small artery of the amputee with a terminal branch of the posterior auricular artery. After replantation, intravenous heparinization was performed and prostaglandin E1 and aspirin were administered. Venous congestion was decompressed by stab incisions applied with heparin solution soaked gauze. Venous congestion of the amputee slowly began to resolve at 4 days after the operation. The amputated segment of the helical rim survived completely with good aesthetic shape and color. The authors propose that performing microvascular anastomosis should be attempted especially if it is possible to detect vessels on cut surfaces of ear amputee and stump. Proper postoperative care for venous congestion, arterial insufficiency, and infection should be followed for amputee survival.
Adult ; Alprostadil ; Amputation ; Amputees ; Arteries ; Aspirin ; Bites, Human ; Ear ; Ear Cartilage ; Heparin ; Humans ; Hyperemia ; Methods ; Microsurgery ; Postoperative Care ; Replantation* ; Skin

Polydeoxyribonucleotide (PDRN) is safe and effective in wound healing, cellular growth, synthesis of extracellular matrix protein, and inflammation reduction via activation of adenosine A2 receptors. We report a 28-year-old male patient treated with PDRN injections for chronic non-healing wound refractory to negative pressure wound therapy, skin graft, or growth factors. Three injections of PDRN were administered at the wound site into the anterior and medial sides of the left stump on the 1st, 4th, and 9th days of hospitalization. The PDRN ameliorated wound healing by enhancing cell growth, tissue repair, and angiogenesis. PDRN application represents a potential treatment for non-healing wounds obviating the need for additional therapies, and hospitalization, as well as improve patient’s activities of daily living.
Activities of Daily Living ; Adult ; Amputees* ; Extracellular Matrix ; Hospitalization ; Humans ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Male ; Negative-Pressure Wound Therapy ; Polydeoxyribonucleotides ; Receptors, Adenosine A2 ; Skin ; Transplants ; Wound Healing ; Wounds and Injuries*