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

本研究的目的是证实一种综合康复治疗的有效性，以满足截肢者的步行能力和住院时间的缩短。材料与方法：对16例患者(对照组8例，因缺血性下肢病行经胫骨截肢手术8例)，采用综合康复方法诱导手术方法、术后硬性敷料、硅胶衬垫加压治疗、碳纤维插座制作人工腿。结果：手术伤口平均愈合时间为15~202天，平均60.5天。术后22~43天(平均28.8天)制作假体，27~85天(平均59天)出院。结论：为满足截肢者的自主寿命和缩短住院时间，综合康复治疗是一种有效的治疗模式。随着人口老龄化的加剧，血管病变的发生率增加，因肢体缺血性疾病而截肢的患者增多。在过去的十年里，在美国，这种缺血性的下肢截肢的比率增加了27%。我们可以利用基于网络的患者记录来处理一个难题，并前瞻性地验证这种综合康复的性质。我们非常荣幸地继续这项关于小腿截肢的循证医学的研究。

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.