Early post-surgical prosthetic fitting with a pre-fabricated plastic limb.

Abstract

Early prosthetic fitting and independent ambulation are major goals in the rehabilitation of amputees with early walking being extremely valuable in the physical and psychosocial rehabilitation of the amputee. With early resumption of weight bearing and ambulation, deterioration of postural reflexes can be prevented and the residual limb (stump) can be shaped for definitive prosthetic fitting. A new temporary prosthesis was evaluated in its use on new below-knee amputees. The prosthesis is a plastic, hollow form which fits over the conventional rigid, plaster postoperative dressing. It comes in one size and is cut to fit the patient. The prosthesis is readily available, needs little training for its application, can be re-used, and is inexpensive. Twenty-two consecutive patients treated at Hines Veteran's Administration Hospital and Loyola University Medical Center underwent below-knee amputations. All were determined to be potential walkers. The average age at surgery was 61 years with a range of 17 to 74 years. Amputation was performed for trauma in two patients and gangrene in the other 20. All wounds were dressed with conventional rigid, plaster dressings with cast changes five days postoperatively. The prefabricated temporary prosthesis was applied at the second cast application at an average of 8.1 days postoperatively with permanent prosthetic fitting at 7.7 weeks. There were no complications related to the use of the plastic temporary prosthesis. The use of a new plastic temporary prosthesis has been found to be advantageous in the early rehabilitation of below-knee amputees.