Table 4 Studies on 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 | Prosthesis-induced risk factor | Study Population | Qualitative results |
|---|---|---|---|---|---|
Mak et al. 2001 [40] | Literature review | Overview over current knowledge about biomechanics in TTAa s | Socket design | NA | - Influence of socket shape on pressure distribution - Need to quantify residuum-socket interactions - Need to address controversies in socket design |
Mak et al. 2010 [9] | Literature review | Overview over experimental and computational studies on tissue deformation and pressure ulcers | Socket design | NA | - Influence of socket interface on transmission of pressure and shear to residual limb - Pressure profile affected by variations in socket and fitting techniques - Even load distribution as way to reduce DTI risk |
Dickinson et al. 2017 [41] | Systematic review | Critical appraisal of state-of-the-art in FEb analysis in TTAs | Socket design | NA | - Influence of socket design and material properties on loading conditions - Clinical translation of FE models necessary |
Bader et al. 2019 [26] | Literature review | Review of Medical Device Related Pressure Ulcers (MDRPUs) and technologies for their detection | Socket design | NA | - Deviations between stiffness of device material and skin/subdermal tissue as major issue - Inadequate guidance for use of devices - Individualisation as key concept |
Portnoy et al. 2012 [32] | Experimental Study | Assessment of differences between hydraulic and ESR feet on internal loading conditions when walking over complex terrain | Prosthetic feet | - 9 unilateral TTAs - Traumatic cause - All male - Mean age 42.7 yrs. - Mean weight 78.2 kg | - Significant decrease in internal stress and loading rates with hydraulic vs ESR feet when walking on paved floor or ascending stairs - Tendency towards internal stress reduction when using split-toed ESR compared to single-toe version |
Lenz 2017 [38] | In Silico Study (PhD thesis) | Investigation of pressure ulcer formation due to deformation, based on gel liner displacement | Prosthetic liner | NA | - Increased interface shear with addition of socks over liner - Cushioning effect of gel liner - Increase in shear stress at bone-muscle interface with no-slip condition - Increase in shear and von Mises but decrease in compression at bone-muscle interface with decreasing liner thickness - Decreased muscle compressive stress with increased liner stiffness |