TY - JOUR
T1 - Transfemoral amputations
T2 - The effect of residual limb length and orientation on gait analysis outcome measures
AU - Bell, Johanna C.
AU - Wolf, Erik J.
AU - Schnall, Barri L.
AU - Tis, John E.
AU - Tis, Laurie L.
AU - Potter, Benjamin K.
N1 - Funding Information:
This research was sponsored by the Department of the Army under Award Number W81XWH-06-2-0073. This award was used to create the Military Amputee Research Program. Funding was used for research support for data collection and analysis.
PY - 2013/3/6
Y1 - 2013/3/6
N2 - Background: The level of function achieved following a transfemoral amputation is believed to be affected by surgical attachment of the remaining musculature, resulting orientation of the femur, residual limb length, and eventual prosthetic fit. Methods: Twenty-six subjects underwent gait analysis testing in the current preferred prosthesis more than twentyfour months postamputation. The femoral length and orientation angles of each subject were measured from standing postoperative radiographic scanograms. The subjects were separated into groups for analysis on the basis of the femoral shaft angles and the residual limb length ratios. Gait analysis was performed to collect kinematic and temporospatial parameters. Results: A good correlation was observed between residual femoral length and trunk with regard to forward lean (r = 20.683) and lateral flexion (r = 20.628). A good correlation was also observed between residual femoral length and pelvic motion with regard to pelvic tilt (r =20.691) and obliquity (r =20.398). Amoderate correlation was observed with speed (r = 0.550), indicating that subjects with shorter residual limbs experienced a greater excursion in the torso and pelvis, while walking at a slower self-selected pace. A significant correlation (r = 0.721, p < 0.001) was observed between the femoral shaft abduction angle and the residual femoral length; the shorter the residual limb, the more abducted it was. Conclusions: The length of the residual femur substantially influences temporospatial and kinematic gait outcomes following transfemoral amputation, and appears to be more important than femoral orientation with regard to these parameters. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
AB - Background: The level of function achieved following a transfemoral amputation is believed to be affected by surgical attachment of the remaining musculature, resulting orientation of the femur, residual limb length, and eventual prosthetic fit. Methods: Twenty-six subjects underwent gait analysis testing in the current preferred prosthesis more than twentyfour months postamputation. The femoral length and orientation angles of each subject were measured from standing postoperative radiographic scanograms. The subjects were separated into groups for analysis on the basis of the femoral shaft angles and the residual limb length ratios. Gait analysis was performed to collect kinematic and temporospatial parameters. Results: A good correlation was observed between residual femoral length and trunk with regard to forward lean (r = 20.683) and lateral flexion (r = 20.628). A good correlation was also observed between residual femoral length and pelvic motion with regard to pelvic tilt (r =20.691) and obliquity (r =20.398). Amoderate correlation was observed with speed (r = 0.550), indicating that subjects with shorter residual limbs experienced a greater excursion in the torso and pelvis, while walking at a slower self-selected pace. A significant correlation (r = 0.721, p < 0.001) was observed between the femoral shaft abduction angle and the residual femoral length; the shorter the residual limb, the more abducted it was. Conclusions: The length of the residual femur substantially influences temporospatial and kinematic gait outcomes following transfemoral amputation, and appears to be more important than femoral orientation with regard to these parameters. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
UR - http://www.scopus.com/inward/record.url?scp=84876425919&partnerID=8YFLogxK
U2 - 10.2106/JBJS.K.01446
DO - 10.2106/JBJS.K.01446
M3 - Article
C2 - 23467863
AN - SCOPUS:84876425919
SN - 0021-9355
VL - 95
SP - 408
EP - 414
JO - Journal of Bone and Joint Surgery
JF - Journal of Bone and Joint Surgery
IS - 5
ER -