Marzoug E A, Landham T L, Dance C, Bamji A N
King's College Hospital.
Disabil Rehabil. 2003 Sep 16;25(18):1071-4. doi: 10.1080/0963828031000148610.
To avoid wastage of prostheses and unfair selection methods for prosthetic prescription, we aimed to develop a practical assessment tool for amputees with doubtful potential, using refurbished second hand modular prostheses.
Thirty-seven primary amputees (33 transfemoral, 4 transtibial; 22 males, 15 females; median age 71 years, range 19-91) were considered to have doubtful potential for prosthetic use, due to single or multiple impairments. Amputees were assessed using custom-made socket and refurbished second-hand modular prostheses. Liability issues were fully covered.
Two patients died before completing the assessment. Median duration of assessment was 4 weeks (range 1-31 weeks). Among the 35 amputees who completed the trial, 14 (38%) proceeded to final prosthesis successfully and 21 (58%) decided to abandon the prostheses. The main reasons for prostheses rejection identified by the team were: hip flexion deformity (4); frailty (4); bilateral amputations (4); COAD (6), stroke (4), stump pain (3) and contralateral leg problems (2)
High prosthetic rejection rate was expected and confirmed in this group (58%), but considerable number did proceed to definitive prosthesis. The method is practical and fair for amputees of doubtful potential, with considerable cost saving.
为避免假肢浪费以及假肢处方选择方法不公平，我们旨在使用翻新的二手模块化假肢，为潜在情况存疑的截肢者开发一种实用的评估工具。
37例初次截肢者（33例经股骨截肢，4例经胫骨截肢；22例男性，15例女性；年龄中位数71岁，范围19 - 91岁）因存在单处或多处损伤，被认为假肢使用潜力存疑。使用定制接受腔和翻新的二手模块化假肢对截肢者进行评估。责任问题得到充分保障。
2例患者在完成评估前死亡。评估的中位时长为4周（范围1 - 31周）。在完成试验的35例截肢者中，14例（38%）成功进入最终假肢适配阶段，21例（58%）决定放弃使用假肢。团队确定的放弃使用假肢的主要原因包括：髋关节屈曲畸形（4例）；身体虚弱（4例）；双侧截肢（4例）；慢性阻塞性肺疾病（6例）、中风（4例）、残端疼痛（3例）以及对侧腿部问题（2例）。
该组预期并证实了较高的假肢放弃率（58%），但仍有相当数量的患者进入了最终假肢适配阶段。该方法对于潜在情况存疑的截肢者来说既实用又公平，且能节省大量成本。
