ACPOC - The Association of Children's Prosthetic-Orthotic Clinics Founded in 1978

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Stump Sensation and Prosthetic Use in Juvenile Upper Extremity Amputees

Eleven, developmentally normal children over the age of 4 years, with unilateral upper extremity amputations were studied. Amputation stump and normal limb sensation were measured by standard two-point discrimination technique. Testing for two-handed function, with and without the prosthesis, was performed using a standardized test battery. The pattern and degree of use of the prosthesis was obtained by questionnaire. Statistical analysis of the data was performed using Statsview II software on a Macintosh II computer.

Although our series is small, a statistically significant enhancement of stump sensation, as compared to the contralateral limb, occurs in the congenital amputees. A number of strong trends were also seen, in the absence of any conflicting trends. The sensory enhancement does not appear to be age dependant. There appears to be a correlation between sensory enhancement and improved stump function, as well as increased prosthetic rejection.

The results of this study support the hypothesis that sensory alterations affect prosthetic use in the population studied. Whether this phenomenon occurs at the cortical level primarily, or due to peripheral axonal sprouting is not known. Further refinement of the sensory testing techniques in a larger series could provide a quantitative predictor of prosthetic use in these types of patients. This work may also be of benefit in the area of sensory feedback prosthetics.

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