Clinical and statistical stump characteristics for identifying contraindications to prosthesis

Introduction Limb amputation impacts physical activity and quality of life. Complications of limb amputation and prosthesis are essential for individuals who are losing limbs from vascular diseases and in military casualties.The objective was to identify contraindications to prosthesis based on clinical and statistical stump characteristics.Material and methods Medical records of 253 lower limb amputees aged 18 to 85 years including 15 individuals with bilateral amputations and 238 with unilateral amputations caused by mine blast injuries, vascular diseases and infections, peacetime injuries, congenital anomalies, osteomyelitis, osteosarcoma. Assessment of the amputee was produced by multidisciplinary teams at the prosthetic orthopedic company, military hospitals, medical and preventive healthcare institutions in 2023. The patients' stumps were examined radiologically and with ultrasound. A total 228 prostheses were manufactured including 120 for tibia and 108 femur amputees. Stabilometric platform and a rehabilitation complex were used for suitable alignment of lower limb prostheses.Results The stump defects that complicated prosthesis included osteophytes, the fibula cut located distally to the tibia cut, the bone cut protruding to under the skin or a scar, foreign bodies of soft tissues, stiff scars, high location of truncated muscles. Prosthesis was complicated in 59 cases (23.3 %), of which 33 patients (56 %) had absolute contraindications.Discussion The findings indicated the importance of timely assessment and preparation of stumps for effective prosthesis. Modern technologies and rehabilitation methods help improve quality of life of amputees. Pain and psychological difficulties were the main problems associated with primary permanent prosthesis. The multidisciplinary approach appeared to be practical for successful prosthesis and rehabilitation of patients. Limb amputation caused by combat injuries and other reasons is associated with physical challenges affecting the patient's quality of life.Conclusion A failure to maintain proper prosthetic socket fit is an absolute contraindication to prosthesis preventing the patient from prosthetic use after amputation. Inadequately cut tibia, club-shaped or excessively conical stump, a stump being too short or too long, osteomyelitis, impaired wound healing or ulcer, ligature fistulas are relative contraindications.