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[腿部再植后的长期随访]

[Long-term follow-up after leg replantation].

作者信息

Liverneaux P, Delattre O, Thoreux P

机构信息

Service d'Orthopédie, Centre Hospitalier, 17300 Rochefort-sur-Mer Cedex.

出版信息

Rev Chir Orthop Reparatrice Appar Mot. 2005 Sep;91(5):482-6. doi: 10.1016/s0035-1040(05)84367-3.

Abstract

Leg replantation is generally considered to yield good results, particularly since the widespread use of progressive lengthening procedures. This optimism must be weighted against the very long and difficult operative program, the social and occupational implications, and the functional outcome of the replanted limb. We report a case of below knee leg replantation in a young patient whose operative program lasted 29 months. Occupational activities were interrupted for three years. The clinical result was satisfactory but with 14 degrees residual valgus suggesting a potential risk of osteoarthritis and difficult therapeutic decisions. The alternatives to replantation are controversial. Leg transplantation is not a valid option in our opinion. Amputation with orthesis should be considered more often because complications are rare and recovery much shorter. Indications for leg replantation should be considered with prudence.

摘要

腿部再植通常被认为会产生良好的效果,特别是自从广泛使用渐进延长手术以来。这种乐观态度必须与非常漫长且困难的手术过程、社会和职业影响以及再植肢体的功能结果相权衡。我们报告了一例年轻患者的膝下腿部再植病例,其手术过程持续了29个月。职业活动中断了三年。临床结果令人满意,但有14度的残余外翻,提示存在骨关节炎的潜在风险以及艰难的治疗决策。再植的替代方案存在争议。我们认为腿部移植不是一个有效的选择。应更频繁地考虑截肢并安装假肢,因为并发症罕见且恢复时间短得多。腿部再植的适应症应谨慎考虑。

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