The Use of Detailed Motion Analysis in the Evaluation of Prosthetic Gait, and Its Role in Guiding Future Management
PATRICIA A. PAYNE, P.T., GEORGE GARTON, B.S.,JAY NOGI, M.D., AND CHESTER SHARPS, M.D.
Results of a study performed by the Motion Analysis Laboratory at Children's Hospital in Richmond, VA on a 14-year-old male with PFFD type B are presented. The patient has received regular follow-up through our Juvenile Amputee Clinic for hypoplastic development of the right femur, including a proximal pseudoarthrosis with the right iliac wing. An attempt at bone graft fusion of the right proximal femur with the femoral head at 2 1/2 months of age resulted in non-union. He was subsequently managed by Boyd amputation in conjunction with epiphysiodeses of the distal femur and proximal tibia at age 12. In January of 1990, delivery of a right Symes type endbearing unconventional prosthesis with an external hinged knee joint and SACH foot was approved in clinic. This allowed him use of a prosthetic knee for the first time.
Of particular interest in this case is the effect of having to control what is essentially two knees, i.e. his natural knee, plus the prosthetic knee joint. The Motion Analysis Laboratory at Children's Hospital employs a Vicon videobased analysis system along with AMTI force platforms to produce a detailed kinetic and kinematic analysis including specific spatial and temporal parameters. The effect of a "double knee limb segment," as well as future management concerns and recommendations for this particular case are discussed.
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