[Myoelectric prostheses for kindergarten age children. Analysis of first reactions and experiences]

During the last few decades myoelectric prostheses were generally provided for adolescent or adult patients. Since 1991 the availability of smaller sized electric hands in conjunction with technical improvements enabled the introduction of myoelectric prostheses for preschool children.However, this progress remained widely unnoticed in Germany. This study presents the authors' experiences with prosthetic devices for preschool children with unilateral upper limb deficiency (congenital and traumatic). Twenty children received a myoelectric prosthesis between the ages of 2 and 5 years (3.9+/-1.1 years). The follow-up period was 1.7 years. The prosthesis was worn for an average of 5.6 h/day. Our hospital-based intensive training program positively influenced the acceptance rate. All children with a below-hand amputation rejected their prosthesis.However, the general dropout rate in preschool children is conspicuously lower compared to adults. In this study 2.4+/-2.9 repairs per year per patient were required. The susceptibility for repairs in this age group is much higher for myoelectric prostheses compare to body-powered devices. Since the correct indication and the intensive training program significantly influence the acceptance rate, the introduction of myoelectric prostheses to preschool children should take place at specialized centers with an interdisciplinary team composed of orthopedists,occupational therapists,and technicians.