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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

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학술저널
저자정보
Albino, Frank P. (Department of Plastic Surgery, Georgetown University Hospital) Seidel, Rachel (Department of Plastic Surgery, Georgetown University Hospital) Brown, Benjamin J. (Department of Plastic Surgery, Georgetown University Hospital) Crone, Charles G. (Nascott/Hanger Clinic) Attinger, Christopher E. (Department of Plastic Surgery, Georgetown University Hospital)
저널정보
대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제41권 제5호
발행연도
2014.1
수록면
562 - 570 (9page)

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Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.
#Amputation #Disarticulation #Extremity

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참고문헌 (15)

참고문헌 신청
Behr J / 2009 / Pain and pain-related interference in adults with lower-limb amputation: comparison of knee-disarticulation, transtibial, and transfemoral surgical sites / J Rehabil Res Dev 46:963~972 google schola Kulkarni J / 2006 / Survival rates in dysvascular lower limb amputees / Int J Surg 4:217~221 google schola Sansam K / 2009 / Predicting walking ability following lower limb amputation: a systematic review of the literature / J Rehabil Med 41:593~603 google schola Raichle KA / 2008 / Prosthesis use in persons with lower- and upper-limb amputation / J Rehabil Res Dev 45:961~972 google schola Krajbich JI / 1998 / Lower-limb deficiencies and amputations in children / J Am Acad Orthop Surg 6:358~367 google schola

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