Background: Transfemoral amputation is a surgical measure in which the surgeon typically conserves as much tissue and bone as possible. Osseointegrated fixation of prostheses is a promising alternative to conventional socket-based fixation. However, osseointegrated prostheses pose some risk of possible bone fracture under unexpected high-impact loading scenarios, such as a fall, and this should be protected against by a safety element. The aim of the present study was to determine the effect of amputation height on the forces and moments at the bone-prosthesis interface during normal gait and three falling scenarios.
Methods: Forces and moments at four amputation heights were determined from a multi-body simulation driven by data captured from an able-bodied participant.
Findings: In all three falling scenarios, forces were relatively independent of amputation height, while moments generally displayed considerable increases with shorter residual limb length. Peak moments ranged from 105Nm (SD 75) (most distal amputation height) to 229Nm (SD 99) (most proximal amputation height) for a "falling during gait" scenario.
Interpretation: Our findings reveal the dependence of interface loads on amputation height in normal gait and falling. This information may lead to improved prosthesis safety elements against bending moments.
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http://dx.doi.org/10.1016/j.clinbiomech.2013.11.023 | DOI Listing |
J Prosthet Dent
January 2025
Head and Neck Surgeon and Head, Verwelius 3D Lab, Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Statement Of Problem: A nasal prosthesis may compensate for a partial or complete defect of the nose associated with trauma or amputation. However, the design and production is time-consuming, expensive, and expertize-dependent. Computer-generated prosthesis models and 3D printing can optimize the process.
View Article and Find Full Text PDFPLoS One
January 2025
Faculty of Design, Kyushu University, Fukuoka, Japan.
Cycling is a beneficial physical activity for rehabilitating individuals with lower-limb amputations and serves as a feasible leisure sport. However, the optimal bicycle configuration for cycling with a unilateral transtibial prosthesis at leisure levels has not been investigated. For saddle height at professional cycling levels, existing literature suggests utilizing the same configuration as that used by intact cyclists, where the knee reaches 25-35° at maximum extension.
View Article and Find Full Text PDFJ Orthop Case Rep
November 2024
Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Introduction: Proximal femur fractures in below-knee amputees pose significant surgical challenges due to difficulties in positioning and stabilizing the residual limb for fracture reduction. In the current literature, there is no consensus on the optimal management strategy, but the inverted boot positioning method seems to be an adequate and non-invasive technique. However, in our case, this method was not possible due to limited knee flexion, so we describe our technique and compare the different modalities described in the literature, highlighting their advantages and disadvantages.
View Article and Find Full Text PDFProsthet Orthot Int
November 2024
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
Background: In some cultures, shoes are not worn indoors. Prosthesis use barefoot can lead to pressure injuries and loss of balance due to abnormal residual limb loading.
Objective: This study aimed to compare the effect of wearing standard alignment prostheses using barefoot at home and visual alteration on static balance and pressure distribution in individuals with unilateral transfemoral amputations (TFAs) or transtibial amputations (TTAs).
Cureus
October 2024
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
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