Kinetic and Kinematics Parameters of Hip in Gait for a Congenital Longitudinal Tibial Deficiency with Orthoprosthesis and Transfemoral Prosthesis: A Case Study

Abstract

Introduction: Congenital longitudinal tibial deficiency is a rare condition. It is characterized by partial or complete absence of tibia with a relatively intact fibula. Its standard treatment is surgery and employing orthoprosthesis or prosthesis. However, the effects of gaits according to the types of prosthesis is barely known. Methods: Orthoprosthesis is offered to a 30-year-old man experiencing left-side congenital type 1 tibial hemimelia (classified as Jones type 1B) deficiency with thoracolumbar scoliosis and exhibiting a depressed shoulder as well as a stiff knee. He decided to have an amputation to wear a transfemoral (TF) prosthesis comprising a microprocessor-controlled knee. Results: Three-dimensional gait analyses and a 6-minute walk test were performed preoperatively and postoperatively with the orthoprosthesis and TF prosthesis. Furthermore, the kinematics of hip flexion/extension and pelvic anterior/posterior tilt range of the motion degree were increased using TF prosthesis. The result of the kinetics of the hip flexion/extension moment and hip power parameters were affected using the TF prosthesis. Conclusions: This case study suggests that the new prosthesis provides removable and adaptable component; further, it delivers a comfortable sitting experience because of its new socket design and knee joint flexion. Clinical Relevance: Patient satisfaction is better with TF prosthesis than with orthoprosthesis. TF prosthesis is more cosmetic than orthoprosthesis, provides a symmetrical gait pattern, decreases donning and doffing durations, and there is no uncomfortable protrusion when sitting (due to amputation of the foot and leg part).