Efficacy of prosthetic rehabilitation in rotationplasty following Ewing's sarcoma: A case study

PURPOSE: Restoration of functional mobility including gait and balance are fundamental to prosthetic rehabilitation in children with rotationplasty. The literature to characterize and investigate the correlation between postural balance and gait following rotationplasty are scarce. This study examines the characteristics of balance and prosthetic gait in a subject with rotationplasty and checks whether any association exists between them. METHODS: A 14-year-old boy with rotationplasty following Ewing's sarcoma was fitted with a custom made prosthesis. Center of pressure (COP) measures using the HUMAC (R) Balance & Tilt System (CSMi, Stoughton, MA), temporal-spatial gait parameters, and energy expenditure measured by a 10 meter walk test were recorded using the new and old prosthesis. A control subject was used for comparison. RESULTS: The stability score, path length, and average velocity of COP improved in a new prosthesis for both standing conditions. Gait parameters were improved and energy expenditure was marginally reduced with the new prosthesis. However, overall prosthetic gait was significantly different compared to the control subject. CONCLUSION: This subject-centric approach successfully improved balance, gait parameters, and energy expenditure by providing better alignment, fit, and comfort with a custom prosthesis.