Use of lower limb prosthesis among elderly amputees.

Forty-seven elderly patients (21 males and 26 females) with lower limb amputation, and with prostheses fitted were studied. Their ages ranged from 65 years to 91 years old, with an average of 75.4 years. The three most common contributory causes for amputation were diabetes mellitus, vascular occlusion and carcinoma of the skin. Among the lower limb amputations, below knee amputation was the most common (93.6%). About 30% of the patients developed complications from prostheses, the 3 most common in order of frequency were stump pain, pressure ulcers and stump infection. Male patients tended to do better with prostheses than female patients. More male patients wanted prostheses for mobility, while most female patients cited cosmesis as the reason for wanting a prosthetic leg. More male patients used the prostheses more frequently and this was associated with a higher level of function in terms of self care and mobility. Reasons for non-usage of prosthesis were poor-fitting sockets, floppy stump, stump ulcers and infection. Carers of male amputees tended to cope better than those caring for female amputees. Both the present age of patient, and the age at amputation were found not to be a factor in deciding the frequency of usage of prosthesis, and the outcome of success in rehabilitation of the amputee. Psychological factors played an important role in the outcome of rehabilitation. Eighty-five percent of patients who functioned at a lower level despite a relative lack of serious medical condition cited psychological reasons for their poor performance, among which were age and the 'expected' loss of mobility with amputation.