1112 - An immediate fit, adjustable prosthesis system for an adolescent with arthrogryposis: A case study

Case Diagnosis: The patient was a 16 year old with arthrogryposis. Arthrogryposis is a congenital condition that is characterized by multiple joint contractures and generalized muscle weakness. Her medical history included multiple surgeries and use of an AFO on the right lower limb. A tibial derotation osteotomy on the left side had become infected and led to a transtibial amputation. A conventional prosthesis was used for 7 months but became too large due to subsequent reduction in limb volume.

Case Description: As part of a research study at the University of Pennsylvania, the subject, with her father’s permission, agreed to test an adjustable, immediate-fit prosthesis. The socket incorporated a supracondylar design for greater knee stability and is fully adjustable in circumference both distally and proximally. It can provide a more or less snug fit to meet the patient’s preference and accommodate changes in limb volume. The prosthesis was fit and aligned in one session and she was taught to use it. She wore it for a two-month period prior to follow-up. During this time she also had a new conventional prosthesis made. The adjustable prosthesis was preferred over the conventional devices and was used exclusively. Improved comfort, adjustability and greater knee stability from the supracondylar fit of the adjustable socket were cited as the reasons for her preference.

Discussions: We hypothesize that the immediate fit, adjustability and supracondylar design of the novel prosthesis promoted comfort and ease of use.

Conclusions: This test prosthesis is a feasible option for teens who want greater knee stability and an adjustable socket. Research is warranted to study the utility of the immediate fit, adjustable prosthesis more broadly in pediatric and adolescent populations.