Ryan Mooney1, Patrick Carry2, Erin Wylie2, Abby Schultz2, Bryan McNair3, Carol Page4, Susan Biffl5, Travis Heare1. 1. Department of Orthopaedic Surgery, Children's Hospital Colorado, 13123 East 16th Ave, B060, Aurora, CO 80045 USA ; The University of Colorado, Anschutz Medical Campus, Aurora, CO USA. 2. Musculoskeletal Research Center, Children's Hospital Colorado, Aurora, CO USA. 3. Research Institute, Children's Hospital Colorado, Aurora, CO USA ; The University of Colorado, Anschutz Medical Campus, Aurora, CO USA. 4. Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO USA. 5. Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO USA ; The University of Colorado, Anschutz Medical Campus, Aurora, CO USA.
Abstract
PURPOSE: The goal of prosthetic fitting is to provide comfort and functionality to the patient. It is thought that incorporating the use of standing anterior-posterior long leg radiographs (LLR) into the fitting of lower extremity prostheses will provide an objective guide when making adjustments, and be a better assessment of alignment. This study compares prosthetic alignment before and after radiography-guided adjustments. METHOD: This retrospective study was performed at a multidisciplinary amputee clinic on patients with congenital and/or acquired limb deficiencies. Their prosthetic alignment was evaluated by LLR and adjusted as needed. Satisfactory alignment was defined as a mechanical axis angular deviation of ≤1° and a leg length discrepancy of ≤10 mm. RESULTS: A total of 45 unique prostheses from 24 subjects (10 female and 14 male) were included. Post-adjustment radiographs were obtained from 29 prostheses. After the initial prosthetic fitting, the probability of a satisfactory fit was 20.0 % (95 % CI 10.9-34.9 %). Following the baseline adjustment, the probability of a satisfactory fit improved to 53.3 % (95 % CI 37.5-70.9 %). After adjustment number 4, the probability of a satisfactory fit further improved to 76.7 % (95 % CI 41.9-98.0 %). There were also significant improvements in distal offset distance (p = 0.0040) and leg length discrepancy (p = 0.0206). The distal offset distance decreased by an average of 10.7 mm (95 % CI 3.6-17.8), and leg length discrepancy decreased by an average of 3.0 mm (95 % CI 00.48-5.5). CONCLUSIONS: The addition of LLRs to existing fitting methods significantly improves prosthetic alignment and length.
PURPOSE: The goal of prosthetic fitting is to provide comfort and functionality to the patient. It is thought that incorporating the use of standing anterior-posterior long leg radiographs (LLR) into the fitting of lower extremity prostheses will provide an objective guide when making adjustments, and be a better assessment of alignment. This study compares prosthetic alignment before and after radiography-guided adjustments. METHOD: This retrospective study was performed at a multidisciplinary amputee clinic on patients with congenital and/or acquired limb deficiencies. Their prosthetic alignment was evaluated by LLR and adjusted as needed. Satisfactory alignment was defined as a mechanical axis angular deviation of ≤1° and a leg length discrepancy of ≤10 mm. RESULTS: A total of 45 unique prostheses from 24 subjects (10 female and 14 male) were included. Post-adjustment radiographs were obtained from 29 prostheses. After the initial prosthetic fitting, the probability of a satisfactory fit was 20.0 % (95 % CI 10.9-34.9 %). Following the baseline adjustment, the probability of a satisfactory fit improved to 53.3 % (95 % CI 37.5-70.9 %). After adjustment number 4, the probability of a satisfactory fit further improved to 76.7 % (95 % CI 41.9-98.0 %). There were also significant improvements in distal offset distance (p = 0.0040) and leg length discrepancy (p = 0.0206). The distal offset distance decreased by an average of 10.7 mm (95 % CI 3.6-17.8), and leg length discrepancy decreased by an average of 3.0 mm (95 % CI 00.48-5.5). CONCLUSIONS: The addition of LLRs to existing fitting methods significantly improves prosthetic alignment and length.
Entities:
Keywords:
Amputees; Long leg radiographs; Lower extremity; Prosthetic alignment
Authors: M L Martínez-Frías; E Bermejo; P Aparicio; M Blanco; E Burón; L Cuevas; M J Espinosa; J Fondevilla; M Gallo; F Hernández; J J Marco; S Martínez; M C Morales; I Mújica; L Paisán; L Valdivia Journal: Am J Med Genet Date: 1997-12-12
Authors: D M Ehde; J M Czerniecki; D G Smith; K M Campbell; W T Edwards; M P Jensen; L R Robinson Journal: Arch Phys Med Rehabil Date: 2000-08 Impact factor: 3.966