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Attachment of upper arm prostheses with a subcutaneous osseointegrated implant in transhumeral amputees

SALMINGER S; GRADISCHAR A; SKIERA R; ROCHE AD; STURMA A; HOFER C; ASZMANN OC
PROSTHET ORTHOT INT , 2018, vol. 42, n° 1, p. 93-100
Doc n°: 187064
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1177/0309364616665732
Descripteurs : EB21 - BRAS - EPAULE - AMPUTATION DU MEMBRE SUPERIEUR

The stump-socket interface is of utmost importance for prosthetic
function in transhumeral amputees. Stability of this connection may be improved
using a newly designed subcutaneous implant.
The purpose was to
determine the effect of the implant together with customized socket designs on
the range of motion of the shoulder and the prosthetic function compared to
conventional fitting.
STUDY DESIGN: Case series. METHODS:
The range of motion was
measured with scaled metrics and the prosthetic function evaluated with the
Southampton Hand Assessment Procedure and the Box and Block Test. Maximal loading
was measured in straight and 90 degrees flexion of the elbow. RESULTS: The
restriction of range of motion after conventional fitting was decreased from
42.55% +/- 6.56% to 9.23% +/- 14.89% in Patient I and from 62.18% +/- 15.19% to
2.51% +/- 2.49% in Patient II using the implant with customized sockets compared
to range of motion without prosthesis. Both patients showed improved prosthetic
function with the new system compared to conventional fitting. CONCLUSION: The
presented subcutaneous humeral implant, together with customized socket designs
without straps and harnesses to the contralateral shoulder, can maintain almost
complete range of motion of the shoulder. This resulted in improved prosthetic
function and comfort for the patient without constant risk of infection. Clinical
relevance Discomfort and limited prosthetic function are the main reasons for
abandonment especially in transhumeral amputees. Shoulder straps and harnesses
within conventional socket designs may not only lead to pain and skin irritations
at the contralateral shoulder but also limit the range of motion of the shoulder
joint and therefore prosthetic function.

Langue : ANGLAIS

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