PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “ARTIFICIAL LIMB”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,315 records · Page 73Linked to original sources
PubMed1987

[Medical rehabilitation of patients after amputation of the leg in sarcoma].

An analysis of data of 348 patients with malignant tumors of soft tissues has shown that 128 of them had been subjected to the amputation of extremities at different levels. The use of microsurgical techniques favours the improvement of the method of amputation of lower extremities, in particular the transplantation of a calcaneoplantar flap onto the stump end. In order to make the treatment of phantom limb pains more effective acupuncture should be included into the complex of therapeutic measures in addition to traditional methods. Close contacts with prostheses-makers can facilitate earlier prosthesis which can give positive effects on the following rehabilitation of such patients.

Adult↗
PubMed1991

The prosthetic treatment of lower limb deficiency.

The prosthesis required for a child with a transverse deficiency whilst a simple version of that appropriate for the adult follows the same principles. The child with a longitudinal deficiency may require an extension, or orthoprosthesis and this may be combined with surgical reconstruction. The principles, technique of measurement and fabrication methods using both traditional and modern composites are described.

Adolescent↗
PubMed2001

Lower limb amputation. Part 2: Rehabilitation--a 10 year literature review.

Ten years after the ISPO consensus conference on amputation surgery, a search of relevant publications in the Rehabilitation-prosthetics-literature over the years 1990-2000 was performed. The main key-words in this research were: "lower limb, amputation, human and rehabilitation". One hundred and four (104) articles were assessed by reading and from these the authors selected 24 articles. These articles are summarised, under several subheadings in this review article, focussing especially on quality of life, functional outcome and predictive factors.

Activities of Daily Living↗
PubMed1987

The value of stump split skin grafting following amputation for trauma in adult upper and lower limb amputees.

One hundred and twenty adult patients were reviewed in whom split skin grafts were applied to the stump following traumatic amputation of the upper limb (44 amputees) or lower limb (76 amputees). The average follow-up period was seven and a half years after initial amputation. There was delay in prosthetic fitting in all patients. Approximately one third of patients complained of occasional minor ulceration, controlled by removing the prosthesis for a few days or modification of the prosthesis. Further revision surgery, including excision of the grafted skin often combined with proximal bone resection, but not removal of the proximal joint, was necessary in 29% of below-elbow amputees and approximately 50% of below and above-knee amputees. At the above-elbow level, use of skin grafts allowed prosthetic fitting because of preservation of sufficient length of the stump. Despite the fact that revision surgery may often be necessary, split skin grafting has a definite place in the early management of the stump following traumatic limb amputation in the adult. Preservation of stump length with the knee or elbow joint allows easier rehabilitation and lower energy expenditure when using the prosthesis. Partial foot amputation, when combined with skin grafting usually requires subsequent revision to a more proximal level to obtain a satisfactory result.

Amputation Stumps↗
PubMed1989

Tumour related lower limb amputation: a 23 year experience.

This paper records the Dundee experience over 23 years and reports on 42 cases of tumour related lower limb amputations. There were 27 males and 15 females with 37 malignant and 5 benign tumours. Four of the 'benign' tumours proved to be osteoclastoma which were locally malignant. Prosthetic rehabilitation was achieved in all but one case. All patients fitted were able to use their prostheses.

Adult↗
PubMed2001

Modeling the interactions between a prosthetic socket, polyurethane liners and the residual limb in transtibial amputees using non-linear finite element analysis.

Continuing earlier studies into the relationship between the residual limb, liner and socket in transtibial amputees, we describe a geometrically accurate non-linear model simulating the donning of a liner and then a socket. The socket is rigid and rectified and the liner is a polyurethane geltype which is accurately described using non-linear (Mooney-Rivlin) material properties. The soft tissue of the residual limb is modelled as homogeneous, non-linear and hyperelastic and the bone structure within the residual limb is taken as rigid. The work gives an indication of how the stress induced by the process of donning the rigid socket is redistributed by the liner. Ultimately we hope to understand how the liner design might be modified to reduce discomfort. The ANSYS finite element code, version 5.6 is used.

Amputation Stumps↗
PubMed1988

Psychologic testing in amputation rehabilitation.

Sixty adult patients had psychologic testing following successful below- or above-knee amputation surgery. All were considered to be prosthetic candidates based on the evaluation of an experienced multidisciplinary rehabilitation team. Objective psychologic testing revealed that six (10%) had severe deficits in cognitive ability, eight (13%) had covert psychiatric illness, and three (5%) had both. A vigorous attempt at prosthetic limb fitting and gait training was made in every patient in an inpatient rehabilitation unit. Of the 17 patients (28%) who were determined to be poor candidates for prosthetic limb fitting and gait training based on objective psychologic testing, only four (6%) were capable of even minimal use of the prosthesis, and none approached their preamputation level of ambulation. Psychologic testing may play an important role in determining the rehabilitation potential of the dysvascular amputee.

Adult↗
PubMed1997

Finite element modeling and experimental verification of lower extremity shape change under load.

Prediction and measurement of residuum shape change inside the prosthesis under various loading conditions is important for prosthesis design and evaluation. Residual limb surface measurements with the prosthesis in situ were used for construction of a finite element model (FEM). These surface measurements were obtained from volumetric computed tomography. A new experimental method for modeling the shape of the in situ lower residual limb was developed based on spiral X-ray computed tomography (SXCT) imaging. The p-version of the finite element method was used for estimating the material properties from known load and displacement data. A homogeneous, isotropic, linear constitutive model with accommodation of the constitutive soft and hard tissues of the residuum was evaluated with static axial loading applied to the in situ prosthesis and compared with experimental results obtained in a human volunteer. Two FEMs were created for similar coronal cross sections of the below knee residuum under two loading conditions. Agreement between observed (from SXCT) and predicted (from FEA) residual limb shape changes inside the prosthesis were maximized with a single modulus of elasticity for the residuum soft tissue of 0.06 MPa, consistent with previously published results. This methodology provides a framework to predict and objectively evaluate FEMs and determine residuum material properties by inverse methods.

Anthropometry↗
PubMed1997

Management of fibular hemimelia: amputation or limb lengthening.

We reviewed retrospectively 22 patients (23 limb segments) with fibular hemimelia treated by amputation or limb lengthening to evaluate these methods of treatment. There were 12 boys and 10 girls, all with associated anomalies in the lower limbs. Twelve patients (13 limb segments) had early amputation and prosthetic fitting and ten had tibial lengthening using the Ilizarov technique. At the latest follow-up, the twelve patients who had amputation were functioning well and had few complications. The ten patients who had lengthening had suffered numerous complications, and all had needed either further corrective surgery or to wear braces or shoe-raises. Two of the ten lengthened limbs required late amputation for poor function or cosmesis. There were fewer hospital admissions, clinic visits, and periods of absence from school in the amputation group. Our findings suggest that amputation is a more effective method of management than limb-lengthening in severe fibular hemimelia. The Ilizarov method is an attractive alternative for selected patients, but its exact role is not yet established. One problem is that families often have unrealistic expectations of the surgical and prosthetic technology available and may refuse amputation when this has been recommended.

Amputation, Surgical↗
PubMed2004

Prosthetic prescription in the Netherlands: an interview with clinical experts.

In the process of guideline development for prosthetic prescription in the Netherlands the authors made a study of the daily clinical practice of lower limb prosthetics. Besides the evidence-based knowledge from literature the more implicit knowledge from clinical experts is of importance for guideline development. In order to obtain this information the authors performed both an observational study of clinical practice and an interview study with 11 clinical experts from the three key disciplines in this field. The latter study is presented here as a descriptive and qualitative study. The combination of the opinions on prescription criteria given in these semi-structured interviews appeared divided with regard to various options in the prescription of a lower limb prosthesis. However, the implicit knowledge is considered by the authors of importance for the consensus procedure on guideline development. Prosthetic prescription criteria seem to be based on local experience and partly on assumptions. A consensus procedure can lead to improvement of the knowledge about prosthetic prescription.

Artificial Limbs↗
PubMed2003

Is the Rivermead Mobility Index a suitable outcome measure in lower limb amputees?--A psychometric validation study.

OBJECTIVE: To examine the internal consistency, validity, responsiveness and test scalability of the Rivermead Mobility Index. DESIGN: Methodological research (consecutive sampling, prospective longitudinal study). PATIENTS: 140 unilateral lower limb amputees (79 above-knee and 61 below-knee). METHODS: The Rivermead Mobility Index was administered to all patients at the beginning (T0) and at the end (T2) of the prosthetic training. In 70 of the patients, the Functional Independence Measure and a timed walking test were also carried out. RESULTS: The Cronbach's alpha of the Rivermead Mobility Index was 0.85 and the item-to-total correlation coefficients rpb ranged from 0.33 to 0.74 (p < 0.0001), for the items considered, at T0; 4 correlations were not calculated due to the extremely low variability of some item responses (mode > or = 98%). The correlation (rs) of Rivermead Mobility Index score with the motor subscale of the Functional Independence Measure was 0.83 at T0 and 0.69 at T2 (p < 0.0001, for both) and that with timed walking test 0.70 (p < 0.0001) at T2. The effect size was 1.35. The scalability coefficients were below the limits of acceptability. CONCLUSION: When applied in lower limb amputees, the Rivermead Mobility Index is an ordinal measure with adequate levels of a series of psychometric properties, which seems more useful for epidemiological studies than for clinical decision-making in single patients. Further steps should be considered to improve its item selection, response format and scaling properties.

Adult↗
PubMed1980

Case note-a combined end-bearing and patellar-tendon-bearing prosthesis for Chopart's amputation.

Disarticulation between the proximal talus and calcaneous, and the distal navicular and cuboid (Chopart's disarticulation) was probably first performed in Britain by Syme in Edinburgh in 1829. Although initially successful, it fell into disrepute because of equinus deformity that developed as a result of the unopposed action of the soleus-gastrocnemius muscles and tendoachilles on the os calcis. Callosities and corns developed on the anterior aspect of the skin flap. These could become rather painful and troublesome at times. Nevertheless, it is an operation that is performed occasionally, and has a place in the range of conservative distal amputations of the lower limb. Whatever the views of the prosthetic team, they may be faced with a surgical "fait accompli" for which they have to provide a suitable prosthesis. There are various prostheses available but we describe a prosthesis required to fulfil a cosmetic, functional and combined end-bearing and patellar-bearing need.

Adult↗
PubMed1984

Foot loading in amputee stance.

A survey has been carried out to establish information on foot loading in amputee stance. The parameters measured are percentage body weight and the positions of the centres of pressure under each foot. The data was collected in a clinical environment by the use of a Double Video Forceplate (DVF), a tool developed at the Bioengineering Centre. The objective of the survey is to provide background information for the use of the DVF in static alignment of lower-limb prostheses. Results are presented from a number of patients attending the Roehampton Walking Training School, and for a small group of patients attending the Bioengineering Centre for delivery of an experimental below-knee prosthesis. Scattergrams and averaged results provide normative data which can assist in interpretation of DVF displays during individual alignment.

Adolescent↗
PubMed1997

Epidemiology of lower limb amputees in the north of The Netherlands: aetiology, discharge destination and prosthetic use.

The aim of this study was to give a retrospective review of all lower limb amputations performed in the 3 northern provinces of the Netherlands in 1991-1992. Assembled data were compared with the existing information in the National Medical Register (NMR) over the same period. With the participation of all regional hospitals, 473 lower limb amputations from transpelvic to transmetatarsal level were identified. Of the amputations 94% were performed for vascular pathology, 3% for trauma, and 3% for oncologic reasons. After surgery a prosthesis was provided to 48% of the amputees. The actual number of performed amputations exceeds the number of amputations registered by the NMR by 9%. Incidence rates of lower limb amputations in the Netherlands are 18-20/100,000 over the last 12 years. These numbers are lower than in other areas and no sharp decrease in frequency compared with other countries in Western Europe.

Adolescent↗
PubMedDate not supplied

The fitting of amputated and nonamputated diabetic feet. A French experience at the Villiers-Saint-Denis Hospital.

The Villiers-Saint-Denis Hospital in France specializes in the rehabilitation of and fitting of orthoses for lower-limb amputees, who frequently have diabetes mellitus. The percentage of partial-foot amputations has increased relative to the percentage of transtibial or transfemoral amputations. This article describes a complete range of orthoses and prostheses, adapted to each patient, that allow recovery of the standing position, gait ability, and physical activity.

Amputation, Surgical↗
PubMed1991

External loading comparisons between able-bodied and below-knee-amputee children during walking.

The purpose of this investigation was to determine external loading variables that could describe any statistically significant differences between the limbs of below-knee-amputee (BKA) and able-bodied children. Eleven able-bodied children and four BKA children volunteered to participate in this investigation. Force platform data were collected for two consecutive foot falls during two experimental sessions. Significant external load differences existed between the prosthetic limbs and nonprosthetic limbs of BKA children and between limbs of the BKA and able-bodied children. The prosthetic limb generally displayed a subordinate role when compared to nonprosthetic and normal limbs. The nonprosthetic limbs displayed a dominant role when compared to the other limbs. These external loading characteristics of the prosthetic and nonprosthetic limbs may be a logical consequence of the morphologic and functional differences that exist between the groups. It was concluded that as long as the prosthetic limb functions differently from a normal limb, BKA children may have a difficult time walking the same as able-bodied children. It would appear to be advantageous to determine the most appropriate gait pattern for BKA children, given the influence of such factors as prosthetic design, construction, and alignment, rehabilitation, and joint loading.

Adolescent↗
PubMed1990

Amputation or limb-lengthening for partial or total absence of the fibula.

Thirty-two patients who had ablation of the foot by the Syme or Boyd technique for partial or total absence of the fibula, with subsequent fitting of a prosthesis, were compared with eleven patients who had lengthening of the lower limb by the Wagner method, to assess the long-term results of each procedure. The final results were evaluated on the basis of pain, limp, limb-length discrepancy, level of physical activity, and satisfaction of the patient. Of the thirty-two patients who had an amputation, twenty-eight (88 per cent) had a satisfactory result, compared with only six (55 per cent) of the eleven patients who had limb-lengthening. The amount of inequality between the lower limbs was classified as follows: Group I--the foot of the shorter extremity was at the distal third of the contralateral, normal limb, and the percentage of shortening was 15 per cent or less; Group II--the foot of the shorter extremity was at the level of the middle third of the contralateral, normal limb, and the percentage of shortening was between 16 and 25 per cent; and Group III--the foot of the shorter extremity was at the level of the proximal third of the contralateral, normal limb, and the percentage of shortening was greater than 26 per cent. Lengthening was best suited for patients in Group I who had stable hips, knees, and ankles and a plantigrade foot. Patients in Groups II and III were best served by ablation of the foot and fitting of a prosthesis.

Adolescent↗