A clinical standard of stump measurement and classification in lower limb amputees.

The dimensions and healing of 93 consecutive below-knee stumps were studied and based on observations a standard formula of stump classification was constructed (and discussed at the ISPO Meeting in Bologna 1980). Muscular atrophy and redistribution of oedema caused a mean reduction of calculated arbitrary stump volume of about 7% during the first 12 post-operative weeks accompanied by a change in distal circumferential measurement ranging between 7 centimetres reduction and 5 centimetres increase. The classification formula was tested in 135 examinations in 86 patients with 96 stumps in Lund. A new proportional definition of stump length was used. Eighty per cent were ordinary in length and shape. Ten of 59 were conical before one year compared to 12 of 42 after more than one year following amputation. Pain was a problem in 20%. Scar problems are common early but other skin damage increases with time. Skin problems are separated according to cause, i.e. pressure, suction, infection and allergy. One third of below-knee stumps had unhealed wound or damaged skin. Surgical correction was indicated in 2% and prosthetic correction in 7%. Prosthetic correction seemed to be more often needed in below-knee stumps and surgical correction in above-knee stumps.