Description: Upper limb deficiencies in children may be the result of trauma, disease, or congenital problems. Although biomechanical losses are the primary problem associated with a limb deficiency, the loss of such an obvious body part has cosmetic and psychosocial implications as well. Fitting a child with a prosthesis typically is the treatment chosen by families. Presently, there are three types of prostheses available for pediatric amputees, including passive, cable-operated, and myoelectric arms, but the myoelectric appears to be the most popular choice of children and their families. However, there is growing concern among clinicians that, despite its advanced technological capabilities, the myoelectric prosthesis is chosen for aesthetic rather than functional reasons. It is difficult, then, to justify the expense of fitting a myoelectric prosthesis when a more inexpensive prosthesis, or none at all, would be a more appropriate prescription. The question of when to prescribe a myoelectric prosthesis for a pediatric patient remains one of the most controversial questions in the field of prosthetics today due to this cost/benefit issue. In this study, the researcher examined psychological factors that may influence whether or not a child will wear a prosthesis and how that prosthesis will be used. Thirty prosthetics patients of Texas Scottish Rite Hospital for Children and their parents answered questionnaires indicating self-perception, social acceptance, and family functioning. A prosthetic usage diary also was completed. Results indicated a significant relationship between optimal residual limb length and increased wearing time. Other trends in the data are discussed. Consideration of these variables by medical staff can be useful in developing appropriate expectations of adherence to treatment by the patient and the family. Recommendations are made for the prescription of pediatric prostheses that are both cost-effective and beneficial.
Date: December 1996
Creator: Glenn, Shannon M. (Shannon Richardson)