A Comprehensive Rehabilitation for a Transtibial Amputation due to Ischemic Lower Limb Disease

本研究的目的是证实综合康复治疗对下肢缺血性截肢患者的有效性，以满足截肢者的行走能力和缩短住院时间。为了跟踪和评估该方法中定义的参数，我们使用基于网络的患者记录进行信息的在线注册。材料和方法：采用综合康复治疗方法，包括手术方法、术后刚性敷料、硅橡胶内衬加压治疗、碳纤维承窝人工腿制作等结果：手术创面愈合时间15-202天，平均60.5天。我们花了22-43天（平均28.8天）制造假体，27-85天（平均59天），直到出院。与前8例TTA患者相比，缩短了假体制作时间18.7天，缩短了术后50.7天。综合康复是一种既能满足截肢者独立生活又能缩短住院时间的有效治疗方式。由于人口老龄化的迅速发展和血管病变的发生率的增加，由于下肢缺血性疾病导致的下肢截肢正在增加。在过去的十年中，这种缺血性下肢截肢的发生率在美国增加了27%。我们可以通过网络病历来解决下肢截肢这一难题，并前瞻性地验证这种综合康复治疗的性质，为下肢截肢的循证医学继续进行这项研究是我们的荣誉。

The purpose of this study is to confirm the validity of a comprehensive rehabilitation for a transtibial amputation due to ischemic lower limb disease to satisfy both the amputees walking ability and shorting of the hospitalization. To follow up and evaluate parameters defined in this method, we use a web-based patient record for the online registration of information.Materials and Methods: We followed the comprehensive rehabilitation method inducing an operation method, a postoperative rigid dressing, a compression therapy with the silicon liner, and the artificial leg manufacture with the carbon fibre socket for sixteen subjects (8 controls, 8 people with a transtibial amputation due to ischemic lower disease).Results: It took for 15-202 days (mean 60.5) till an operation wound healed completely. We spent 22-43 days (mean 28.8) to manufacture the prosthesis and 27-85 days (mean 59) until discharge km the operation. Compared with data of previous 8 cases of TTA, we can shorten 18.7 days of prosthesis manufacture period and 50.7 days km operation until discharge.Conclusions: To satisfy both amputees independent life and shortening of the hospitalization, a comprehensive rehabilitation is considered to be an effective treatment modality.Due to the rapid aging of population mid the increase in the occurrence of vascular lesions, lower limb amputation due to ischemic lower limb disease is increasing. The rate of such ischemic lower-limb amputations has increased by 27% over the past decade in the USA. We can deal with a difficult problem of lower limb amputation and validate property of this comprehensive rehabilitation prospectively using a web-based patient record.It is our great honor to continue this research for evidence-based medicine about lower leg amputation.