Interventional procedure overview of direct skeletal fixation of limb prostheses using an intraosseous transcutaneous implant

Indications and current treatment

Limb amputation is traumatic and affects QOL. Lower-limb amputation (above or below the knee) is the most common reason for a person to use a prosthetic limb (customised prosthesis). The most common reason for lower-limb amputation is peripheral vascular disease. Other causes include trauma, infection, diabetes and cancer. Upper-limb amputations are less common and are mainly a result of trauma. A small proportion of people need prosthetic limbs because of congenital limb loss or deformities.

The customised prosthesis is fitted to replace the function of the missing limb and provide cosmesis for major amputations. The type of prosthesis depends on what part of the limb is missing. Conventionally, the prosthesis is attached to the residual stump by belts and cuffs, suction, or by a suspension system. The conventional prosthesis usually has a socket, which is custom made from a plaster cast of the stump. One of the main problems with this type of prosthesis is rubbing between the stump and the socket. This can cause pain, ulceration and improper distribution of body weight that can affect balance and lead to falls. This may mean the user has limited use of the prosthesis or may have to abandon it for a period because of poor fit.