Ferrapie A L, Brunel P, Besse W, Altermatt E, Bontoux L, Richard I
CRRRF-CHU Angers, BP40329, 49103 Angers cedex, France.
Prosthet Orthot Int. 2003 Dec;27(3):179-85. doi: 10.1080/03093640308726680.
To analyse survival, prosthetic fitting and functional status after trans-femoral amputation or hip disarticulation for a primitive tumour.
Retrospective study of all patients admitted since 1985.
Mean age at amputation was 55. Causes of amputation were osteosarcoma in 50%. Eight (8) patients had initial conservative surgery. Local recurrence was never observed. Nine (9) developed metastasis and required further hospitalisation. Fifty percent (50%) of patients died. Inpatient rehabilitation started 14 days after amputation (7-27), and was of a mean duration of 32 days. Prosthetic fitting was performed 13 days after admission (7 days when a liner was used). Further improvement of the prosthesis was performed in 10 patients. Among the patients who died, 5 had gone home, 4 were wearing their prosthesis all day long and 2 walked indoors with no additional support at discharge. Three (3) patients lived less than 2 months at home. Among the patients who did survive, all went home, 5 were wearing their prosthesis all day long and 2 walked indoors without aid at discharge. Two (2) patients practised sport and 4 drove. All the patients who were active have gone back to work.
Gain due to prosthesis provision is undebatable. Good functional results can be obtained with adapted materials. Initial problems due to the synchronisation of treatments are resolved with multidisciplinary care. All patients should have a rapid and short hospitalisation in a rehabilitation unit and receive a first, simple prosthesis that can be further adapted.
分析因原发性肿瘤行股骨截肢或髋关节离断术后的生存率、假肢装配及功能状态。
对1985年以来收治的所有患者进行回顾性研究。
截肢时的平均年龄为55岁。截肢原因中骨肉瘤占50%。8例患者最初接受了保肢手术。未观察到局部复发。9例发生转移并需要进一步住院治疗。50%的患者死亡。住院康复在截肢后14天（7 - 27天）开始，平均持续时间为32天。入院后13天（使用内衬时为7天）进行假肢装配。10例患者的假肢得到进一步改进。在死亡患者中，5例已回家，4例全天佩戴假肢，2例出院时在室内行走无需额外支撑。3例患者在家中存活时间不到2个月。在存活的患者中，全部回家，5例全天佩戴假肢，2例出院时在室内无需帮助行走。2例患者进行体育锻炼，4例开车。所有活跃的患者都已重返工作岗位。
提供假肢的益处是无可争议的。使用合适的材料可获得良好的功能效果。治疗同步导致的初始问题通过多学科护理得以解决。所有患者都应在康复单元接受快速且短期的住院治疗，并获得可进一步适配的首个简单假肢。
