The impact of gender, level of amputation and diabetes on prosthetic fit rates following major lower extremity amputation.

This was a retrospective secondary data analysis, so it cannot show that diabetes, gender or amputation level caused the fitting differences. Important factors such as pre-amputation limb salvaging surgery, cognition and specific co-morbidities were not recorded in the database. Only short-term outcomes up to discharge from rehabilitation were measured; function, mobility and quality of life were not assessed. Only below-knee and above-knee amputations were analysed; other levels were excluded because of small numbers or specific rehabilitation and prosthetic requirements. Diabetes status was confirmed from notes but not categorised further, so the study could not examine differences between diabetes categories. Women made up 36% of the cohort, and specific co-morbidities were not investigated, so the measured co-morbidity index did not explain the gender difference in fitting.

The authors declared no potential conflicts of interest and received no financial support for the research, authorship or publication.

Do not read the diabetes finding as proof that diabetes causes poorer prosthetic fitting. The study was observational, diabetes did not predict fitting after below-knee amputation, and the above-knee association may reflect unmeasured complications rather than a proven effect.