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PubMed1978

Instrumented measurement of human joint motion.

Accurate measurement of human joint motion is essential to the design and evaluation of internal joint prostheses and artificial limb replacements. A triaxial electrogoniometer instrumented by three miniature precision potentiometers was developed to fulfill this task. A special linkage was used to attach this apparatus externally to the joint. Three-dimensional angular motion following the classical Eulerian angle definition was measured in real time. The error due to exoskeletal attachment was corrected by the method of 4 x 4 matrix. This technique is now being routinely used for objective functional evaluation on the patients with abnormal hip, knee and ankle joints as well as lower extremity amputees fitted with artificial limbs.

Ankle Joint↗
PubMedDate not supplied

Jaipur limbs.

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Artificial Limbs↗
PubMed1995

Amputees: skin problems and prostheses.

Once lower-extremity amputees become accustomed to wearing an artificial limb, they want to continue using it. Of considerable concern to the dermatologist, prosthetist, and the entire clinical team is prevention of any disorder that might return such patients to crutches or bed rest. The importance of early recognition and treatment of skin lesions on the stump of amputees cannot be overemphasized. Heavy demands are placed on the stump skin by the artificial limb. Even a minor skin eruption may, through neglect or mistreatment, become an extensive disorder that will seriously threaten the amputee's mental, social, and economic rehabilitation.

Adult↗
PubMed1991

[Degenerative changes in the sacroiliac joint in persons with amputations of the thigh and biomechanical disorders of gait].

In order to evaluate degenerative changes with amputated persons' sacroiliacal joints--upper leg amputations, 20 male subjects aging 31-57 years and a control group of 56 subjects with no amputation were tested. Changes evaluation was confirmed by a radiologic and scintigraphic result. Changes were observed after amputation-0 level 6 months' walk with an artificial limb. There was a comparison to a control group-56 subjects with no amputation. After evaluating degenerative changes of lumbocoxal triangle it could be concluded that the amputation and the time of amputation were a relevant factor in the beginning of degenerative changes. 6-12 months after the amputation, sacroiliacal joint's degenerative changes on ipsylateral side begin using an adequate orthopedic expedient-an artificial limb used permanently, degenerative changes can be held up at reversibility level or stagnation. Using an adequate physical therapy and an orthopedic expedient by an early discovery of degenerative changes their progress can be prevented.

Adult↗
PubMedDate not supplied

[Prosthetic management of the elderly following amputation of the lower extremities].

We report on 162 patients with one- or two-sided amputations above the ankle joint. Seventy-nine percent of these patients were candidates for artificial limbs; substantial differences are shown in respect to the height of the amputation: there are considerably more patients who can use a prosthesis after a lower leg amputation than after one- or two-sided upper leg amputation. Counterindications for prostheses were, on the whole, principally arterial scleroses. As expected, almost 95% of the one-side amputees, and approximately 100% of the (considerably younger) both-side amputees were discharged from hospital with a degree of self-sufficiency. Some of the patients not provided with an artificial limb were able to return home as well (87.5%). Absolute independence was seldom reached and social assistance had to be arranged for many amputees.

Activities of Daily Living↗
PubMed2001

[The German Orthopedics Society 1918-1932. Developments and trends].

The German Orthopedic Society was founded in 1901. The period between 1918 and 1932 was characterized by the aftermath of World War I. Up to the middle of the 2nd decade, orthopedic surgeons mainly treated soldiers and civilians affected by the war. Almost every congress dealt with amputations and artificial limbs. At the same time, orthopedic surgery became a specialty at the German universities, legitimizing it as a subject of its own. Besides the large number of victims of the First World War who had to be treated by orthopedic surgeons, there was a second group of patients, the so-called cripples. These handicapped people had not previously been treated in general. A new law established in 1920 guaranteed the government's support for treatment and education of these patients. This law was called "Krüppel-Fürsorge-Gesetz," which entailed welfare but also resocialization of the handicapped, including their return to work. The German nation recognized the economic benefit of this law and accepted the financial burden. During this period, German orthopedic surgeons developed many important surgical techniques, diagnostic tests, and technical findings for the production of orthoses and artificial limbs. Some examples of techniques are described in the article: UVirradiation for the treatment of rickets according to K. Huldschinsky, Borggreve's rotationplasty of the leg (Umkehrplastik), hallux valgus arthroplasty according to Brandes, and Bragard's sign.

Artificial Limbs↗
PubMed2003

[FDG PET as an early nuclear medical diagnostic tool for aseptic wear-induced loosening of hip joint endoprostheses--a report of two cases].

To date, 2-[F-18]fluoro-2-deoxy-D-glucose PET (FDG PET) is used as a tool in oncology as well as myocardiological and cerebral functional diagnostics in the clinical routine. False positive results of tumor search imply new possibilities for use in diagnostics of inflammation. The two case reports presented here on aseptic loosening of endoprostheses caused by the rub of polyethylene with histological and immunohistological refurbishing call attention to the possible diagnostic valency of FDG PET as an early warning system regarding aseptic artificial limb loosening induced by the rub of polyethylene. By quantification of glucose metabolism with the "standard uptake value" (SUV) as well as specific storage samples from around the artificial limb, it is the aim of our study group in further examinations to develop an algorithm which permits to distinguish between septic and aseptic loosening.

Acetabulum↗
PubMed2004

[Rehabilitation of patients after lower limb amputation as a basic element of adaptation to normal life].

Amputations of bottom limbs are serious problem. Loss of leg causes always heavy psychical injury, it makes life more difficult, as well as moving and self-service. The change of appearance and shape of body demands adaptations of patient and his neighbourhood. Every amputation is not only heavy physical injury but also violent and long-lasting psycho-emotional and social stress. Most of patients are afraid of unknown, so it's necessary to decrease their fear, they expect our help in solving their social and domestic problems. The aim of investigations is to show the process of adapting to normal life of people after amputation of bottom limb on example of their rehabilitation. The following investigative methods were used: steered observation, interview, Polish version of questionnaire RNL (reintegration to normal living) in small modification and inquiry. Investigations were conducted in two hospital wards and the rehabilitation centre. The group consisted of 82 patients--59 men (72% of group) and 23 women (28%). The numerous group (43%) were people between 50-69 years old. Only a few patients after amputation go to special out-patients' department. The main reason of it is the lack of rehabilitation centre in the neighbourhood. 1/5 of the group regularly uses rehabilitation at expert, however most patients over 70s do not use any rehabilitation. Frequent form of activity at studied people is morning exercises and easy exercises of stump. Lack of physical activity is typical for 1/3 of group. Physically active are only 12 patients (15%). Near half of the group uses artificial limbs, but 1/5 of group does not want to have it. Most of them is over 70 years old. Results of investigation show the need of opening the larger quantity of rehabilitation centres to make the rehabilitation more common and accessible. Essential meaning has also bigger motivation of patients to physical activity as well as using artificial limbs, which do facilitate functioning in everyday life and improve the mood of patients after amputation.

Activities of Daily Living↗
PubMedDate not supplied

[Rehabilitation of workers with amputated limbs].

New technologies such as modular prostheses and prostheses fitted with a myoelectrical control mechanism have made it possible for individuals who have suffered amputation of the lower or upper limbs to be reinstated in work. Many examples of artificial limbs are illustrated that have given excellent cosmetic and functional results. Obviously, good functional recovery depends on the facilities, the environment, the cooperation experts engaged in rehabilitation, on retraining and reinstatement at work, and only the combined efforts of all sectors can ensure that the many obstacles can be overcome, as the author's twenty-year experience has shown.

Adolescent↗
PubMed1980

A clinical study of amputations of the lower limb.

A retrospective study of 525 cases of lower limb amputation attending the Outpatient Department of the Rehabilitation and Artificial Limb Centre and various rural clinics from January 1976 to March 1978 was carried out. Males outnumbered females and the majority of cases were in the 3rd decade. Trauma was the most common cause of amputation followed by peripheral vascular disease and neoplastic lesions. The stump was considered to be satisfactory in more than half of the cases studied. Proper postoperative care was lacking in most of those amputated at other centres.

Adolescent↗
PubMed2001

Silicone roll-on suspension for upper limb prostheses: users' views.

OBJECTIVE: To determine the perceived benefit, pattern of use and problems of the ICEROSS socket for upper limb prostheses. DESIGN: Structured questionnaire sent to patients provided with ICEROSS systems. SETTING: NHS artificial limb clinic. SUBJECTS: All patients (20) who have used an upper limb prosthesis with an ICEROSS inner socket between 1995-1999. MAIN OUTCOME MEASURES: Purpose-designed questionnaire. RESULTS: Replies were obtained from 18 patients. Eight (8) amputees continue to use their ICEROSS limb regularly (44%) after a mean of 32 months. Ten (10) amputees stopped using the ICEROSS system. Six (6) developed persistent skin problems, 2 switched to myoelectric prostheses, 1 was unable to put the ICEROSS on independently and 1 amputee stopped using all kinds of prostheses because he did not find them useful. Fourteen (14) amputees complained of phantom pain, 4 of whom reported worsening of the pain with ICEROSS sockets. CONCLUSION: The ICEROSS socket provides good suspension for upper limb prostheses, but its use is limited by skin problems and incompatibility with myoelectric contacts.

Adolescent↗
PubMed1996

Amputation surgery and prostheses.

Wide surgical margins in surgery for a bone tumor can be accomplished either by local excision or by amputation surgery. Amputation surgery has less morbidity than limb salvage surgery. Prosthetic replacement in the lower-extremity amputation should provide an artificial limb that will be comfortable and stable for weight bearing. Retention of the anatomic knee joint is critical for better ambulation and less energy expenditure. Upper-extremity prosthesis should be functional and cosmetically acceptable.

Amputation, Surgical↗
PubMed1994

A study of 200 cases of congenital limb deficiencies.

An analysis of 200 patients with congenital limb deficiency who attended the Artificial Limb Centre, Pune from January 1984 to April 1990 is presented. This group is representative of the congenital limb deficient population of the country. The commonest deficiencies were transverse phalangeal total/partial deficiency and transverse forearm partial deficiency (below elbow) in upper limbs, whereas transverse metatarsal total/partial deficiency and transverse leg partial deficiency (below knee) were commonest in lower limbs. Transverse forearm partial deficiency was more common in female, while transverse leg partial deficiency was more common in male children, 16 patients did not require any treatment, 6 needed only surgical correction. Some 30 patients needed surgery before prosthetic fitting, while 148 patients required only prostheses. Some 68% of patients achieved satisfactory to excellent results; 18% showed poor rehabilitation. No definitive cause for the deformities could be isolated; however, many parents believed that possible exposure to the eclipse during pregnancy was the cause of the deficiency. The eldest child was most affected.

Adolescent↗
PubMed1987

Foot loading characteristics of amputees and normal subjects.

The foot loading characteristics of 100 consecutively attending amputees wearing their definitive prostheses were studied during their routine visits to the Artificial Limb and Appliance Centre. Results were compared with observations on 100 age and sex matched controls who were free from any locomotor disability. The parameters measured were the percentage of body weight borne on each foot, the positions of the centres of pressure under each foot and the position of the overall centre of foot pressure. The results demonstrate the range of variability of these parameters in normal subjects of different ages and provide preliminary indications of the patterns associated with different types of prostheses and different levels of amputation. The information was collected using the Double Video Forceplate (DVF) a tool developed for the rapid assessment of stance, at University College London Bioengineering Centre. It is proposed that the DVF may be useful in assisting prosthetic alignment, in clinical teaching of prosthetists, physiotherapists and doctors and in monitoring of patients with lower limb amputation.

Amputees↗