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

本研究的目的是为了证实对缺血性下肢疾病所致经胫截肢患者进行综合康复治疗的有效性，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在线注册。材料与方法：对16例患者（对照组8例，下肢缺血性疾病行胫骨截肢者8例）采用手术法、术后刚性敷料、硅衬垫加压治疗、碳纤维支架人工腿制造等综合康复方法。结果：手术创面愈合15 ~ 202 d，平均60.5 d。制作假体用时22-43天（平均28.8天），术后出院用时27-85天（平均59天）。与以往8例TTA相比，可缩短假体制作周期18.7天，缩短km操作至出院时间50.7天。结论：综合康复是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。由于人口快速老龄化中期血管病变的发生增多，因下肢缺血性疾病而截肢的下肢正在增多。在美国，这种缺血性下肢截肢的发生率在过去十年中增加了27%。我们可以处理下肢截肢的难题，并利用基于网络的患者记录验证这种综合康复的前瞻性。我们很荣幸能够继续这项关于下肢截肢的循证医学研究。

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.