Measurement of maximal end-weight-bearing in lower limb amputees

Modern sockets for lower limb amputees utilize total contact and distribute some weight on the stump end. Its tolerance to bear weight varies but is better after joint disarticulation, however, systematic measures have been missing. Different levels, indications, shapes etc. were analysed with 102 measurements in 69 patients. The maximal-end-weight-bearing of the stump measured on a scale was much lower after transmedullar amputations than after disarticulations. Men had a mean tolerance more than 15 kg but women less than 10 kg. There was a positive correlation to body weight. Diabetics tolerated significantly more end-bearing and patients with phantom pain more than patients with stump pain. Within each category of stumps the range of maximal end-weight-bearing was large. Among all below-knee amputees the tolerance was between 2 to 55 kg or 3 to 79 per cent of body weight. Pointed stumps statistically tolerated about as much as rounded ones and the variability of contact surface was not measured as its sensitivity to pain must be unevenly distributed. It is concluded that this simplified method is helpful to analyse pain and to modify end-weight-bearing more individually.