Use and satisfaction with prosthetic devices among persons with trauma-related amputations - A long-term outcome study

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 collec ted for a retrospective cohort of persons with a lower limb trauma-related amputation who received their acute care at the University of Maryland R. A dams Cowley Shock Trauma Center, Baltimore, MD, between 1984 and 1994. Pati ents with spinal cord injury, traumatic brain injury, or only toe amputatio ns were excluded. Results: There were 146 patients identified. Of those, 9% died during the a cute admission and 3.5% died after discharge. Seventy-eight amputees were a vailable for interview (68% response rate). The majority of those interview ed were male (87%), and two-thirds had undergone amputation before age 40 y r. Nearly 95% had a prosthesis and wore it an average of 80 hr (SD = 33) pe r week. Despite high use, only 43% reported being satisfied with the comfor t of their prosthesis. About one-quarter of all users reported problems wit h wounds, skin irritation, or pain. Traumatic amputees used an average of f our prostheses since injury, about one new prosthesis every 2 yr. Statistic al analyses revealed that males reported higher prosthetic use (P < 0.01). Higher Injury Severity Score negatively impacted on prosthetic use (P < 0.0 1). Phantom pain negatively influenced reported satisfaction with the prost hesis (P <less than> 0.03) Conclusions: Although almost all persons living with trauma-related amputat ions use prosthetic devices, the majority are not satisfied with prosthetic comfort. Phantom pain and residual limb skin problems are also common affl ictions in this population.