American Journal of Physical Medicine & Rehabilitation · 2004 · 25 citations · 0 references
MedicineOrthopaedic SurgeryOrthopedic SurgeryAmputation RehabilitationOrthoticsProstheticsAmputationGait BiomechanicsLower-limb ProstheticsProsthetic BiomechanicsProsthetic DevicesProsthetic RehabilitationCarbon Fiber Prosthetic ComponentsControl Group DesignCustom-molded FootwearGaitMatched Control GroupProsthetic Footwear IntegrationTransmetatarsal AmputationTransmetatarsal Prostheses
OBJECTIVE: To determine whether the design of a transmetatarsal amputation prosthesis with a carbon-fiber plate would improve gait pattern in patients with transmetatarsal amputations. DESIGN: In the gait laboratory in a tertiary medical center, eight male patients with transmetatarsal amputations were recruited. Nine able-bodied male volunteers were recruited as the control group. A full-length standard shoe and a transmetatarsal amputation prosthesis with a carbon-fiber plate were the footwear used. Our transmetatarsal amputation prosthesis included a custom-molded insole, a mounted toe filler, and a thin, lightweight, carbon-fiber plate incorporated directly beneath the insole. RESULTS: After wearing the transmetatarsal amputation prosthesis with a carbon-fiber plate, the results of the kinetic and kinematic studies were summarized. CONCLUSION: The transmetatarsal amputation prosthesis with a carbon-fiber plate improved gait pattern significantly in patients with transmetatarsal amputations. Drastic shoe modifications are not necessary to have the prosthesis inserted. The carbon-fiber plate functions like the spring-steel shank within the sole of the shoe. The carbon-fiber plate, the toe filler, and the total-contact insole are all mounted as a whole to ensure better foot contact. Therefore, our transmetatarsal amputation prosthesis with a carbon-fiber plate can be a good alternative choice of footwear in patients with transmetatarsal amputations.