The evolution of the Canadian-type hip-disarticulation prosthesis.
The evolution of the Canadian-type hip-disarticulation prosthesis.
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加拿大型髋关节离断假体的演变。
DOI：
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发表时间：
1957
期刊：
影响因子：
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通讯作者：
Mclaurin Ca
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作者：
Mclaurin Ca
1美国西北大学修复学研究中心助理主任，401 E。俄亥俄州街，芝加哥;曾任多伦多桑尼布鲁克医院加拿大退伍军人事务部假肢服务中心研究工程师。没有多少人是截肢者。更少的人是假肢专家。没有多少截肢者是髋关节离断病例。因此，没有多少假肢感兴趣的髋关节离断假肢，除非在场合的要求。这就是髋关节假体的历史。更深入地观察这幅图，可以发现解决这个问题的两种或多或少的标准方法，但通常有很多变化，因为有limbshops。附图（Fig. 1至6）指出了常规装配的实践，如果不是原理的话，以及一些变型。对传统试衣原则的研究更能说明问题。指导原则似乎是这样的：取一条标准的膝盖以上的腿，并在其上进行改造，直到它可以绑在截肢者身上。实践肯定证明了这一点。即使是“倾斜台假肢”这个术语也建议从腿一直到残肢，而不是从截肢者开始，截肢者应该是任何康复尝试的焦点。这种对问题的间接处理方法并不是肢体康复者所独有的。水管工对连接水管比对家庭用水需求更感兴趣。飞机驾驶员更关心飞机的配平，而不是乘客座位的舒适度。假肢师的主要兴趣在于为顾客做一条适合他的腿，在这方面，他表现出了相当大的独创性。如果这些变化不是地方性的，也许可以取得更大的进展。许多装配工已经令人惊讶地接近了哥伦布式假肢，毫无疑问，其他人实际上设想了基本原理，但没有实现机械设计。一般来说，与其他膝盖以上的个案比较，髋关节离断的个案被视为非常不幸。也许这种态度的部分原因是，许多病例不是创伤造成的，因此预期寿命很短。无论如何，结果是不鼓励截肢者对他的假肢有太大的期望。通常的抱怨本质上是机械性的--关节发出嘎嘎声，需要经常修理。因此，假体的大多数创新都是为了解决这些机械问题，并且更多地是偶然而不是设计功能优势。传统的髋关节离断假体通常分为两大类，碟型和更常见的倾斜型。
1 Assistant Director, Prosthetics Research Center, Northwestern University, 401 E. Ohio St., Chicago; formerly Research Engineer, Prosthetic Services Centre, Canadian Department of Veterans Affairs, Sunnybrook Hospital, Toronto. Not many people are amputees. Still fewer people are prosthetists. Not many amputees are hip-disarticulation cases. Hence, not many prosthetists are interested in hip-disarticulation prostheses except when occasion demands. That just about sums up the history of hipdisarticulation prosthetics. A more intensive look at the picture reveals two more or less standard approaches to the problem, but usually there are as many variations as there are limbshops. The accompanying illustrations (Figs. 1 through 6) indicate the practice, if not the principle, of conventional fitting, together with some of the variants. A study of the principles of conventional fitting is even more revealing. The guiding one seems to be this: Take one standard above-knee leg and build on to it until it can be strapped to the amputee. The practice certainly bears this out. Even the term "tilting-table prosthesis" suggests working from the leg up to the stump, instead of beginning with the amputee, who properly should be the focal point in any attempt at rehabilitation. This back-handed approach to problems is not something unique among limbfitters. The plumber is more interested in joining pipes than he is in the water requirements of a household. The airplane pilot is more concerned with the trim of the aircraft than with the comfort of the passengers' seats. The prosthetist's main interest lies in making a leg he can fit on the customer, and in so doing he has shown a considerable amount of ingenuity. Perhaps had the variations not been local in nature, more progress could have been made. Many fitters have come surprisingly close to the Canadian-type prosthesis, and no doubt others actually envisioned the basic principles without achieving the mechanical design. Generally speaking, the hip-disarticulation case has been considered very unfortunate when compared with other above-knee cases. Perhaps some of this attitude is owing to the fact that a great many cases are not of traumatic origin and that therefore the life expectancy is short. In any event, the result is that the amputee is not encouraged to expect much from his prosthesis. The usual complaints are mechanical in nature—rattling in the joints and the need for frequent repair. Accordingly, most innovations in the prostheses have been directed toward solving these mechanical problems, and more by chance than by design functional advantages evolved. Conventional hip-disarticulation prostheses are usually classified into two main categories, the saucer type and the more common tiltingtable type.