Sathishkumar S, Manigandan C, Asha T, Charles J, Poonoose P Pradeep
Joint Amputation Clinic, Christian Medical College, Vellore, Tamil Nadu, India.
Int J Rehabil Res. 2004 Mar;27(1):71-4. doi: 10.1097/00004356-200403000-00010.
Early ambulation after lower extremity amputation has profound benefits on the functional, psychological outcomes and enhanced prosthetic compliance among this clientele. The various potential risks of immobility--pain, oedema, muscle atrophy, phantom sensations, contractures, aerobic de-conditioning, and the like, are reduced due to early ambulation. Moreover, it assists in accelerated wound healing, preservation of postural reflexes and, above all, achievement of better psychological well-being. Though such benefits have been observed in the history of prosthetic rehabilitation, a cost-effective prosthesis for such an early management among Third World nations is still unavailable. Therefore, this article is an attempt to present an indigenously developed temporary prosthesis designed to make the above benefits possible at a lower cost. This prosthesis helps in myriad ways--immediate prosthetic fitting, early weight bearing, early ambulation--and also has the added advantage of being adjustable to anthropological variations. The ischial weight bearing, lateral opening socket reduces the pressure and shear over the stump, thus avoiding stump complications. This increases the prosthetic acceptance by the client due to early involvement in the rehabilitation. Above all, it is cost effective and comfortable, thus enhancing compliance and superior outcome in prosthetic rehabilitation, especially among the clients in Third World nations.
下肢截肢后早期活动对这类患者的功能、心理状况以及提高假肢适配性具有深远益处。早期活动可降低因长期不活动带来的各种潜在风险，如疼痛、水肿、肌肉萎缩、幻肢感觉、挛缩、有氧能力下降等等。此外，它有助于加速伤口愈合，保持姿势反射，最重要的是，能使患者获得更好的心理健康。尽管在假肢康复史上已观察到这些益处，但在第三世界国家，仍没有一种经济高效的假肢可用于这种早期治疗。因此，本文试图介绍一种自主研发的临时假肢，该假肢旨在以较低成本实现上述益处。这种假肢在诸多方面发挥作用，如即时假肢装配、早期负重、早期活动，并且还具有可根据人体学差异进行调节的额外优势。坐骨承重、外侧开口的接受腔可减轻残肢上的压力和剪切力，从而避免残肢并发症。这因患者能早期参与康复过程而提高了对假肢的接受度。最重要的是，它经济高效且舒适，从而提高了假肢康复的依从性并带来更好的效果，尤其是在第三世界国家的患者中。
