Sorry for the odd sequence- Part 1 of the responses was still too long and
was rejected on the first attempt.
My original question was: —–Original
Message—–
From: Ted Trower
Date: Fri, 21 Jan 2011 17:20:18 -0500
Subject: [OANDP-L] Amputee complexity score?
I’m looking at
some management processes and it strikes me that it might be
reasonable to attempt to score the complexity of any particular amputee
fitting, prior to beginning the fitting process.
I cannot say I’ve ever seen this done or referred to, but for assessing
outcomes in a reasonable manner it seems it would be necessary.
My first impulse is to simply add up the number of medical / surgical
complications present in the individual. There has to be a better way
but
it would certainly be simple.
=======================
No matter the score or the complexity of the system, it is all
subjective and no scientific data to support functional k-level scores.
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I think that your concept has merit both in the real world of
Prosthetics and also to assist the Case manager / Third Party payor in
their approval process.. My first thought is to see if one of the
O&P
Schools is willing to tackle such an idea (possibly a grad student or
Resident for a project.
I’d like to see posts.
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I have often thought of this. It is really similar to some of the
orthopedic
classification systems (Salter-Harris fractures for example). The
key
is
that it must have an impact on treatment or payment for it to be
used
and be
effective, as well as be objective and as reproducible as possible.
I would think that complications are only part of the issue. Time
since amp,
length of limb (too long or too short), soft tissue (heavy vs
light)
wound
healing, sensation, strength, motivation, pain, medications,
previous
prosthetic use, age etc etc , would need to be incorporated into
what
makes
a limb easy or difficult to fit. Not sure that helps but from an
outcomes
perspective, that is where I would go.
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You might check with the emergency folks because they have triage
tables to rate who gets seen first.
————————————————————————————–
Ted A. Trower CPO, FAAOP
A-S-C Orthotics & Prosthetics
Jackson, MI
Continuing Education Chairman
Michigan Orthotics & Prosthetics Association
