This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Postema, K Articles by Poelma, M J Search for Related Content PubMed PubMed Citation Articles by Postema, K Articles by Poelma, M J Social Bookmarking                   What's this?

Prosthesis rejection in children with a unilateral congenital arm defect

V van der Donk

J van Limbeek

R AJ Rijken

M J Poelma

St Maartenskliniek, Nijmegen, The Netherlands

Objective: To determine the rate of rejection for prosthetic use in children and to investigate reasons for this rejection.

Design: Cross-sectional study of a cohort of children.

Setting: Rehabilitation centre, St Maartenskliniek, Nijmegen, the Netherlands.

Subjects: Thirty-two children (0–18 years) with a unilateral congenital arm defect who visited the clinic between September 1991 and December 1996.

Methods: Parents of all children and 19 children (years) completed a questionnaire.

Results: Eleven children (34%) rejected the prosthesis. A survival function shows that the rejection can be characterized by three periods: 0–40 months, 40–162 months and after 162 months. In the first and last period a high rate of rejection is seen, while in the second period a low rate exists. Fitting for the first time after 2 years of age seems to be related with higher rejection rate. Lack of functional gain with the prosthesis, as perceived by the subjects and the parents, is significantly associated with increased rejection rate. Increased rejection rate is associated with the parents' disappointment, insufficient involvement of the parents in treatment, and dissatisfaction pertaining to emotional and social guidance.

Conclusions: Rejection seems to occur in two main periods: within 3.5 years after being provided with a prosthesis and after 13.5 years of prosthetic use, when most children experience puberty. Fitting before the age of 2 years seems to reduce rejection rate. Preventing the parents' disappointment about prosthetic benefits as well as providing them with sufficient involvement in treatment and adequate guidance are essential for optimal results of prosthetic rehabilitation.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. A. James, A. M. Bagley, K. Brasington, C. Lutz, S. McConnell, and F. Molitor Impact of Prostheses on Function and Quality of Life for Children with Unilateral Congenital Below-the-Elbow Deficiency J. Bone Joint Surg. Am., November 1, 2006; 88(11): 2356 - 2365. [Abstract] [Full Text] [PDF]

				J. R. Davids, L. V. Wagner, L. C. Meyer, and D. W. Blackhurst Prosthetic Management of Children with Unilateral Congenital Below-Elbow Deficiency J. Bone Joint Surg. Am., June 1, 2006; 88(6): 1294 - 1300. [Abstract] [Full Text] [PDF]