Long-term results of early myoelectric prosthesis fittings: A prospective case-control study

Background: Different recommendations exist regarding what age is best for first-time fitting of myoelectric hand prostheses in children. Objectives: To compare prosthetic skill, prosthetic use and risk for rejection over time between children fitted with myoelectric hand prostheses before or after 21/2years of age. Study design: Prospective case-control design. Methods: The cases were nine children fitted with myoelectric hand prostheses before the age of 21/2years, whereas the controls were 27 children who were fitted with myoelectric hand prostheses after the age of 21/2years. The Skills Index Ranking Scale was used to classify prosthetic skill, and prosthetic use was categorised based on wearing time and pattern. Independent samples tests were used to compare data between groups. To estimate and compare the risk of prosthesis rejection between groups and over time, survival analysis was used. Results: Cases showed prosthetic skill early, but controls had caught up by the age of 31/2years. Cases had a significant (p=0.046) decrease in prosthetic use at the age of 9years. In the long term, cases had a higher percentage of prosthesis rejection. Conclusions: Considering young children's development of prosthetic skill and prosthetic use over time, this study shows no additional advantages from fitting a myoelectric hand prosthesis before 21/2years of age. Clinical relevance Children may be fitted with myoelectric hand prostheses to assist in daily tasks and to prevent future over-use problems. Most children fitted with myoelectric hand prostheses before 4years of age become regular users. No advantages of fitting myoelectric hand prostheses before 21/2years of age were observed.