STUMP PROBLEMS IN TRAUMATIC AMPUTATION

Stump problems in amputations resulting from employment related injuri es were investigated in 397 cases in the Chugoku and Shikoku districts of Japan between 1987 and 1991. Ninety-seven patients (24%) had stump problems which interfered the prosthetic fitting. Stump problems of t he upper extremity were seen in about 9% (17 amputees), two thirds of which were skin troubles. Stump problems of the lower extremity were s een in about 37% (80 amputees). Certain complaints were associated wit h specific methods of amputation; abnormal keratosis in Syme's amputat ion, equinus deformity in Chopart's amputation, reduced muscle power i n above the knee (A/K) amputation and joint dysfunction in below the k nee (B/K) amputation. Adequate prosthetic fitting was achieved by the modification of the socket and alignment in almost all amputees with s tump problems. In only two cases, Chopart's amputation required subseq uent Syme's amputation due to equinus deformity with abnormal keratosi s. In almost every case, stump problems are avoidable by means of surg eons' deliberate evaluation of the affected limb and adequate choice o f the amputation level.