Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review
- Jutamanee Poonsiri, Pieter U. Dijkstra & Jan H. B. Geertzen (2021) Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review, Disability and Rehabilitation, DOI: 10.1080/09638288.2021.1893393
- DOI: 10.1080/09638288.2021.1893393
Abstract
Purpose
In persons with a hip or knee flexion contracture ≥25°, fitting a prosthesis is said to be difficult. This systematic review aims to assess the evidence for fitting of a prosthesis in persons with a severe contracture (≥25°) after a lower limb amputation.
Method
PubMed, Embase, Scopus, CINAHL, and Orthotics & Prosthetics Virtual Library databases were searched from inception to December 2019, using database specific search terms related to amputation, prosthesis, and contracture. Reference lists of included studies were checked for relevant studies. Quality of the included studies was assessed using the critical appraisal checklist for case reports (Joanna Briggs Institute).
Results
In total, 13 case studies provided evidence for fitting of a prosthesis in more than 63 persons with a transtibial amputation and three with a transfemoral amputation, all of whom had a hip or knee flexion contracture ≥25°. Some studies found a reduction in contractures after prosthesis use.
Conclusions
Several techniques for fitting a prosthesis in case of a flexion contracture ≥25° were found. Contracture reduction occurred in some cases and was possibly related to prosthesis use. Fitting a transtibial or transfemoral prosthesis in persons with a lower limb amputation with a severe flexion contracture is possible.
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