Residual limb volume change: systematic review of measurement and management

Abstract

Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. This systematic review assesses what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: group I: descriptions of residual limb volume measurement techniques; group II: studies investigating the effect of residual limb volume change on clinical care in people with lower-limb amputation; and group III: studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. We found that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, limited evidence exists regarding the management of residual limb volume, and the evidence available focuses primarily on adults with transtibial amputation in the early postoperative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required.

Figure 1

Time post-amputation of all studies reviewed in groups II and III shown in black text (except for Pinzur et al.^[54] and Wilson et al.^[53] who did not report data on people with lower-limb amputation, and Nawijn et al.^[17] which was a review of multiple studies). For reference, the gray text indicates post-amputation phases taken from AAOP report on post-operative management of persons with amputation^[5].