Transfemoral Amputations: The Effect of Residual Limb Length and Orientation on Gait Analysis Outcome Measures
Transfemoral Amputations: The Effect of Residual Limb Length and Orientation on Gait Analysis Outcome Measures
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DOI：
10.2106/jbjs.k.01446
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发表时间：
2013-03-06
影响因子：
5.3
通讯作者：
Potter, M. A. J. Benjamin K.
中科院分区：
文献类型：
--
作者：
Bell, Johanna C.;Wolf, Erik J.;Potter, M. A. J. Benjamin K.
背景资料：经股截肢后实现的功能水平被认为是受影响的剩余的肌肉组织的外科手术附件，导致方向的股骨，残肢长度，并最终prosthetic fit.Methods：26名受试者进行步态分析测试，在目前首选的假体超过24个月postamputation。从站立位术后X线扫描照片测量每个受试者的股骨长度和方向角。根据股骨干角度和残肢长度比将受试者分组进行分析。结果：股骨残余长度与躯干前倾（r = -0.683）和侧屈（r = -0.628）相关性良好。股骨残余长度与骨盆倾斜度（r = -0.691）和骨盆活动度（r = -0.398）之间也存在良好的相关性。观察到与速度的中度相关性（r = 0.550），表明残肢较短的受试者在以较慢的自选步伐行走时，躯干和骨盆的偏移较大。显著相关股骨干外展角与股骨残端长度呈显著正相关（r = 0.721，p < 0.001），残端长度越短，股骨干外展角越大。残余股骨的长度显著影响经股截肢后的时空和运动步态结果，并且就这些参数而言似乎比股骨方向更重要。
Background: The level of function achieved following a transfemoral amputation is believed to be affected by surgical attachment of the remaining musculature, resulting orientation of the femur, residual limb length, and eventual prosthetic fit.Methods: Twenty-six subjects underwent gait analysis testing in the current preferred prosthesis more than twenty-four months postamputation. The femoral length and orientation angles of each subject were measured from standing postoperative radiographic scanograms. The subjects were separated into groups for analysis on the basis of the femoral shaft angles and the residual limb length ratios. Gait analysis was performed to collect kinematic and temporospatial parameters.Results: A good correlation was observed between residual femoral length and trunk with regard to forward lean (r = -0.683) and lateral flexion (r = -0.628). A good correlation was also observed between residual femoral length and pelvic motion with regard to pelvic tilt (r = -0.691) and obliquity (r = -0.398). A moderate correlation was observed with speed (r = 0.550), indicating that subjects with shorter residual limbs experienced a greater excursion in the torso and pelvis, while walking at a slower self-selected pace. A significant correlation (r = 0.721, p < 0.001) was observed between the femoral shaft abduction angle and the residual femoral length; the shorter the residual limb, the more abducted it was.Conclusions: The length of the residual femur substantially influences temporospatial and kinematic gait outcomes following transfemoral amputation, and appears to be more important than femoral orientation with regard to these parameters.