Introduction: Different recommendations exist on what age is best for first-time fitting of myoelectric hand prosthesis (MEP) in children.
Objectives: To compare prosthetic skill, prosthetic use and risk for rejection over time between children fitted with MEP before or after 2½ years of age.
Method: A prospective case-control design was chosen. Cases were children fitted with MEP before age 2½ years (median 17 months, range 8-22) whereas controls were fitted with MEP from age 2½ years (median 36 months, range 33-42). 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 based on age, prosthetic skill and prosthetic use at certain ages. To estimate and compare risk of prosthesis rejection between groups and over time, survival analysis was used.
Results: Cases showed prosthetic skill early, but controls did catch up at age 3½. Cases had a significant (p= 0.046) decrease in prosthetic use at age 9. In the long term, cases had a higher percentage of rejecting their prosthesis.
Conclusion: Considering a young child’s development of prosthetic skill and prosthetic use over time, this study shows no additional advantages from fitting a myoelectric hand prosthesis very early. So, in conclusion, a recommended age for fitting myoelectric hand prosthesis in children is from 2½ years of age, with further consideration taken to the individual psychosocial and motor development.