Stefan Salminger1,2, Heiko Stino2, Lukas H Pichler3, Clemens Gstoettner2, Agnes Sturma2,4, Johannes A Mayer2, Michael Szivak5, Oskar C Aszmann1,2. 1. Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria. 2. Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Vienna, Austria. 3. AUVA Trauma Center Linz, Linz, Austria. 4. Department of Bioengineering, Imperial College London, London, UK. 5. Department of Medical Documentation and Statistics, Austrian Trauma Insurance Agency (AUVA), Vienna, Austria.
Abstract
PURPOSE: There is a large body of evidence demonstrating high rates of prosthesis abandonment in the upper extremity. However, these surveys were conducted years ago, thus the influence of recent refinements in prosthetic technology on acceptance is unknown. This study aims to gather current data on prosthetic usage, to assess the effects of these advancements. MATERIALS AND METHODS: A questionnaire was sent to 68 traumatic upper limb amputees treated within the Austrian Trauma Insurance Agency between the years 1996 and 2016. Responses were grouped by the year of amputation to assess the effect of time. RESULTS: The rejection rate at all levels of amputation was 44%. There was no significant difference in acceptance between responders amputated before or after 2006 (p = 0.939). Among users, 92.86% (n = 13) used a myoelectric, while only one amputee (7.14%, n = 1) used a body-powered device. Most responders complained about the comfort (60.87%, n = 14) as well as the weight of the device (52.17%, n = 12). CONCLUSIONS: The advancements of the last decade in the arena of upper limb prosthetics have not yet achieved a significant change in prosthetic abandonment within this study cohort. Although academic solutions have been presented to tackle patient's complaints, clinical reality still shows high rejection rates of cost-intensive prosthetic devices.Implications for rehabilitationAbandonment rates in prosthetic rehabilitation after upper limb amputation have shown to be 50% and higher.The advancements of the last decade in the arena of upper limb prosthetics have not yet achieved a significant change in prosthetic abandonment.Well-structured and patient-tailored prosthetic training as well as ensuring the amputee's active participation in the decision making process will most likely improve prosthetic acceptance.
PURPOSE: There is a large body of evidence demonstrating high rates of prosthesis abandonment in the upper extremity. However, these surveys were conducted years ago, thus the influence of recent refinements in prosthetic technology on acceptance is unknown. This study aims to gather current data on prosthetic usage, to assess the effects of these advancements. MATERIALS AND METHODS: A questionnaire was sent to 68 traumatic upper limb amputees treated within the Austrian Trauma Insurance Agency between the years 1996 and 2016. Responses were grouped by the year of amputation to assess the effect of time. RESULTS: The rejection rate at all levels of amputation was 44%. There was no significant difference in acceptance between responders amputated before or after 2006 (p = 0.939). Among users, 92.86% (n = 13) used a myoelectric, while only one amputee (7.14%, n = 1) used a body-powered device. Most responders complained about the comfort (60.87%, n = 14) as well as the weight of the device (52.17%, n = 12). CONCLUSIONS: The advancements of the last decade in the arena of upper limb prosthetics have not yet achieved a significant change in prosthetic abandonment within this study cohort. Although academic solutions have been presented to tackle patient's complaints, clinical reality still shows high rejection rates of cost-intensive prosthetic devices.Implications for rehabilitationAbandonment rates in prosthetic rehabilitation after upper limb amputation have shown to be 50% and higher.The advancements of the last decade in the arena of upper limb prosthetics have not yet achieved a significant change in prosthetic abandonment.Well-structured and patient-tailored prosthetic training as well as ensuring the amputee's active participation in the decision making process will most likely improve prosthetic acceptance.
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