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11 Mix*: 2 bilateral Syme's amputation, 3 Syme's-B/K, 1 Syme's-A/K 1 bilateral through knee, 1 A/K through hip

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13 2. Kegel, B., Carpenter, M. L. and Burgess, E. M.: Functional Capabilities of Lower Extremity Amputees. Arch. Phys. Med. Rehabil. 59, , Kerstein, M. D., Zimmer, H., Dugdale, F. E. and Lerner, E.: Amputations of lower extremity: a study of 194 cases. Arch. Phys. Med. Rehabil. 55, , Narang, I. C., Mathur, B. P., Singh, P. and Jape, V. S.: Functional Capabilities of Lower Limb Amputees. Prosthetics and Orthotics International 8, 43-51, English, A. W. G. and Gregory, D. A. A.: The artificial Limb Service. Health Trends, Vol. 12, No. 4, November, pp , Hunter, G. A., Holliday, P.: Review of function in bilateral lower limb amputees. Can. J. Surge. 21, , Spurgeon, M. J.: Chronic Effects of Bilateral Leg Amputations. South. Med. J. 70, No. 9, 1148, Volpicelli, L. J., Chambers, R. B. and Wagner, F. W. Jr.: Ambulation levels of bilateral lower extremity amputees. Analysis of one hundred and three cases. J. Bone Joint Surg. (Am). 65, , Van De Ven, C. M.: An investigation into the management of bilateral leg amputees. Br. Med. J. 283, , 1981.

14 Rehabilitation of bilateral lower extremity amputees Toshihiro SUGIHARA Department of Orthopedic Surgery, Okayama University Medical School Impairments and disabilities of forty-two bilateral lower extremity amputees resistered at the Okayama Prefectural Rehabilitation Center from 1967 to 1983 were analysed. Sixty-nine percent of the amputation were related to trauma. The incidence of amputation due to vascular disorders were lower in Okayama than in Western countries. Sixty percent of the cases ranged from twenty to sixty years of age. The average age of the amputees was lower than that in Western coutries. In eighty seven percent of the amputees, skin erosion and sweating were major complaints. Therefore, the development of sweat-absorbable sockets is an important project. Lock or safety knee joints were used for A/K prostheses in order to obtain good knee stability. Of six high level amputees, three were confined to a wheel chair. Thirty nine amputees were able to walk with prostheses. One third of the cases had no job after prosthetic training. Eighty-one percent of all cases were married. The rate of employment and marriage was much higher than in Western countries. From these findings, it can be said that bilateral lower extremity amputees are rehabilitated fairly well in Okayama.

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