Met Rosemarie, Janssen Linda I, Wille Jan, Langezaal Adeline E, van de Mortel Rob W H, van de Pavoordt Eric D W M, de Vries Jean-Paul P M
Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands.
Vasc Endovascular Surg. 2008 Oct-Nov;42(5):456-61. doi: 10.1177/1538574408316914. Epub 2008 May 5.
The objective was to evaluate our results on functional outcome for both through-knee amputations and above-knee amputations. Functional outcome was measured using the Special Interest Group in Amputee Medicine score, which focuses on walking distance and use of prosthesis. From 1997 to 2006, 39 through-knee amputations (53%) and 34 above-knee amputations (47%) were performed. Eight (21%) of 39 through-knee amputations needed to be converted to above-knee amputations. Fifty patients (24 above-knee amputations, 26 through-knee amputations) were eligible for follow-up. During follow-up, 71% (of above-knee amputations) and 69% (of through-knee amputations) did not walk with a prosthesis, and 29% of above-knee amputations and 27% of through-knee amputations walked more or less than 50 m. In conclusion, only a minority of patients is able to walk with a prosthesis, and a lot of the through-knee amputations need conversion to a higher level. On the basis of this results, it would be preferable to perform a straight above-knee amputation instead of a through-knee amputation if the correct amputation level is in doubt in high-risk patients.
目的是评估我们在膝下截肢和膝上截肢功能结局方面的结果。使用截肢医学特别兴趣小组评分来衡量功能结局，该评分侧重于步行距离和假肢使用情况。1997年至2006年期间，共进行了39例膝下截肢（53%）和34例膝上截肢（47%）。39例膝下截肢中有8例（21%）需要转为膝上截肢。50例患者（24例膝上截肢，26例膝下截肢）符合随访条件。在随访期间，71%（膝上截肢患者）和69%（膝下截肢患者）未使用假肢行走，29%的膝上截肢患者和27%的膝下截肢患者行走距离或多或少超过50米。总之，只有少数患者能够使用假肢行走，并且许多膝下截肢需要转为更高平面的截肢。基于这些结果，如果高危患者的正确截肢平面存在疑问，进行直接的膝上截肢而非膝下截肢可能更为可取。
