Prostheses for persons with lower-limb amputations: An extra joint increases range of motion

This report describes two cases in which the addition of an extra joint enh anced range of motion and improved function in persons with unilateral lowe r-limb amputation. Both individuals had significant disability in the workp lace and at home before this modification. In the first case, an individual with a hemipelvectomy had inadequate hip-joint flexion for maneuvering dur ing photo shoots. In the second case, the individual's transfemoral prosthe sis provided insufficient knee flexion for kneeling and working in tight sp aces. In each case, a manual-locking, single-axis knee joint was added adja cent to the joint with the limited range of motion. In both cases, the addi tion of the second joint provided the increased flexibility needed. The fir st person's hip-flexion range improved from 125 degrees to 190 degrees, and the second person's knee-flexion range improved from 140 degrees to 170 de grees, In repeated follow-up, both patients remained highly satisfied with the intervention. The addition of an extra joint is an option that should b e considered when inadequate range interferes with function. (C) 1999 by th e American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.