Table 3 Studies on non-prosthesis induced risk factors for DTI
From: Exploring the role of transtibial prosthetic use in deep tissue injury development: a scoping review
Author and year | Type of Study | Objective | Non-prosthesis induced risk factors | Study Population | Qualitative Results |
|---|---|---|---|---|---|
Henrot et al. 2000 [39] | Literature review | Overview over surgical features of amputation in relation to postoperative stump pain | Tissue Morphology | NA | - Postoperative complications: Heterotopic ossification, aggressive bone edges, pistoning, ulceration - Extrinsic pain: caused by improper fit or alignment - Intrinsic pain: nervous or anatomical cause |
Portnoy et al. 2007 [37] | In silico study | Determination of internal stress in muscle flap of TTAa; influence of bone sharpness, tissue thickness, mechanical properties | Tissue Morphology,Mechanical Properties | - Use of data from Portnoy et al. 2007 [29] | - Increase in pressure with reduced flap thickness - Increase in pressure with increased muscle stiffness - No clear relationship between bone radius and pressure |
Portnoy et al. 2009 [30] | Experimental study | Determination of inter-subject variability in internal tissue loads in TTA with different geometrical features during static loading | Tissue Morphology | - 5 unilateral TTAs - Traumatic cause - 1 female, 4 male - Mean age 48.6 yrs. - Mean weight 67.8 kg | - High inter-subject variability - Risk of DTI for patients with little fat padding - More even pressure distribution with flat compared to sharp tibial ends - Lower strains with longer residua |
Portnoy et al. 2009 [36] | In silico study | Identify influence of risk factors on internal loadingonditions in TTA | Tissue Morphology,Mechanical Properties | - 1 unilateral TTA - Traumatic cause - Male - Age 44 yrs. - Weight 82 kg | - Thicker muscle flap and increased bone radius reduce DTI risk - Osteophyte, sharp bevelment and muscle stiffening increase risk - Surgical scars change overall stress distribution |
Kosasih et al. 1998 [28] | Experimental study | Identify sensory changes in well healed TTAs | Sensory impairment | - 9 unilateral TTAs - Traumatic cause - All male - Mean age 55.4 yrs. - Weight not specified | - No deep pressure sensory impairment in well healed TTA stumps |
Mak et al. 2001 [40] | Literature review | Overview over current knowledge on biomechanics in TTAs | Sensory impairment | NA | - Neuropathy leading to usually preventable soft tissue damage |
Bader et al. 2019 [26] | Literature review | Analysis of bioengineering tools for device related soft tissue damage | Sensory impairment | NA | - Risk factors: neuromuscular impairments, diabetes |