Use of Prostheses and Footwear in 110 Inner-City Partial-Foot Amputees

Abstract

The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of all levels. The results showed that about one-half of all patients wore a shoe-insert orthosis. Although 54% wore some form of special footwear to accommodate and protect the residual foot, no patient in this study wore a shoe with a rocker-bottom sole. Only one patient with a transmetatarsal amputation used a brace and only one patient in the entire study wore a modern cosmetic foot prosthesis.

Comparison of quality of life in people with partial foot and transtibial amputation

“…Our preliminary results do not support common beliefs that QoL is better for people with dysvascular PFA compared to those living with TTA. [11][12][13]52 While our findings require corroboration by other investigators, they highlight the need to reconsider the advice given to patients facing difficult decisions about limb loss. Based on our sample, a patients' age, time living with diabetes and the presence of retinopathy had a significant effect on QoL and should feature in discussions about amputation at the partial foot or transtibial level.…”

Quality of life in persons with partial foot or transtibial amputation

“…30,31 In spite of the low rates of wound healing and frequent re-amputation to a more proximal level, PFA is often preferred to TTA given the purported functional benefits. [32][33][34][35][36][37][38][39] For example, it is commonly reported that preserving the ankle joint and residual foot length will contribute to a more normal and less-energy-expensive gait, 32,34,37,[39][40][41] despite good evidence that amputation proximal to the metatarsal heads results in a gait pattern almost indistinguishable from that of persons with TTA. 38,39,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] As the emerging evidence suggests that differences in gait and energy expenditure between PFA and TTA are unlikely, more holistic measures of health such as QoL have become of increasing interest.…”