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Use and Satisfaction with Prosthetic Devices Among Persons with Trauma-Related Amputations: A Long-Term Outcome Study

Dillingham, Timothy R. MD, MS; Pezzin, Liliana E. PhD; MacKenzie, Ellen J. PhD; Burgess, Andrew R. MD

American Journal of Physical Medicine & Rehabilitation: August 2001 - Volume 80 - Issue 8 - p 563-571
Research Article: Prosthetics

Dillingham TR, Pezzin LE, MacKenzie EJ, Burgess AR: Use and satisfaction with prosthetic devices among persons with trauma-related amputations: a long-term outcome study. Am J Phys Med Rehabil 2001;80:563–571.

Objective To document and examine the use, satisfaction, and problems with prosthetic devices among persons who suffered a trauma-related lower limb amputation.

Design Abstracted medical records and follow-up interview data were collected for a retrospective cohort of persons with a lower limb trauma-related amputation who received their acute care at the University of Maryland R. Adams Cowley Shock Trauma Center, Baltimore, MD, between 1984 and 1994. Patients with spinal cord injury, traumatic brain injury, or only toe amputations were excluded.

Results There were 146 patients identified. Of those, 9% died during the acute admission and 3.5% died after discharge. Seventy-eight amputees were available for interview (68% response rate). The majority of those interviewed were male (87%), and two-thirds had undergone amputation before age 40 yr. Nearly 95% had a prosthesis and wore it an average of 80 hr (SD = 33) per week. Despite high use, only 43% reported being satisfied with the comfort of their prosthesis. About one-quarter of all users reported problems with wounds, skin irritation, or pain. Traumatic amputees used an average of four prostheses since injury, about one new prosthesis every 2 yr. Statistical analyses revealed that males reported higher prosthetic use (P < 0.01). Higher Injury Severity Score negatively impacted on prosthetic use (P < 0.01). Phantom pain negatively influenced reported satisfaction with the prosthesis (P < 0.03)

Conclusions Although almost all persons living with trauma-related amputations use prosthetic devices, the majority are not satisfied with prosthetic comfort. Phantom pain and residual limb skin problems are also common afflictions in this population.

From the Department of Physical Medicine and Rehabilitation (TRD), Johns Hopkins University; Emergency Medicine Department (LEP), Johns Hopkins University School of Medicine; Center for Injury Research and Policy (EJM), Johns Hopkins University School of Hygiene and Public Health; R. Adams Cowley Shock Trauma Center (ARB), University of Maryland School of Medicine, Baltimore, Maryland.

Supported, in part, by Grant R49/CCR302486 from the Centers for Disease Control and Prevention.

The views expressed in this article are those of the authors. No official endorsement by the Centers for Disease Control and Prevention or the Department of Health and Human Services is intended or should be inferred.

All correspondence and requests for reprints should be addressed to Timothy R. Dillingham, MD, 10352 Waverly Woods Drive, Ellicott City, MD 21042-1666.

© 2001 Lippincott Williams & Wilkins, Inc.