Evaluating the temporary pylon and permanent prosthesis in a rehabilitation amputee clinic.

1 Area Supervisor, South Carolina Vocational Rehabilitation Department, Greenville, S. C. 29601. We in vocational rehabilitation need to stop occasionally and examine our procedures with a critical eye. We get engrossed in the job at hand, and find it amazingly easy to neglect determining whether there might be a better way to accomplish a task, thereby improving our services to handicapped people. Recently, we decided to look at our amputee clinics in an attempt to evaluate two methods being used to fit recent lowerextremity amputees with prostheses. We had been following the conventional, medically recommended policy of seeing the amputee after the stump had healed and shrunk. At that time, the amputee was instructed in the proper method of wrapping the stump with elastic bandage to aid shrinkage, and the clinic chief determined when measurements for a prosthesis could be obtained. This seemed to be the way to prepare an amputee for an artificial limb. However, prosthetic clinic teams in other parts of the country began using a temporary pylon, or preparatory prosthesis, instead of wrapping with an elastic bandage, with good results. We felt the need to evaluate those two methods with the following questions in mind: What are the actual costs in each case? Which procedure permits the amputee to work sooner? From the medical viewpoint, does one method of fitting an amputee have advantages over the other?