University of Miami School of Medicine, Miami, Florida, USA.
Nurs Clin North Am. 1967 Sep;2(3):399-408.
With the use of modern prosthetic appliances and the initiation of early ambulation, satisfactory function can be expected in the vast majority of below-knee amputees. The rehabilitation of the above-knee amputee is more difficult and the performance of these patients does not compare favorably with that of the below-the-knee amputee. Immediate postsurgical fitting appears to have resulted in a higher percentage of successful below-knee amputations in patients with peripheral vascular disease. The rigid dressing provided by the temporary prosthesis applied to the stump immediately after the amputation seems to control excessive edema and places the severed tissues in an environment more conducive to uneventful healing. Myoplastic techniques and early ambulation are not necessary prerequisites for the use of the immediate postsurgical fitting technique. Below-knee myoplasty should not be performed in patients with peripheral vascular disease because of its questionable value and the undesirable additional surgical trauma that this technique requires. Early weight-bearing ambulation is not a prerequisite for the use of the immediate postsurgical fitting technique and may be instituted only in cases in which the patients' general condition, balance, and coordination are sufficiently intact to permit supervised instructions. The application of the temporary pylon requires wide prosthetic experience and extreme care.
通过使用现代假肢和早期开始行走，绝大多数小腿截肢患者都可以预期获得满意的功能。大腿截肢患者的康复则更加困难，他们的表现不如小腿截肢患者。术后立即安装假肢似乎使患有周围血管疾病的患者的小腿截肢成功率更高。截肢后立即应用临时假肢提供的刚性敷料似乎可以控制过度肿胀，并将切断的组织置于更有利于顺利愈合的环境中。肌肉成形技术和早期行走并不是立即进行术后安装假肢技术的必要前提。由于存在疑问的价值和这种技术所需的不良额外手术创伤，不应该对患有周围血管疾病的患者进行小腿肌肉成形术。早期负重行走不是使用立即术后安装假肢技术的前提条件，只有在患者的一般状况、平衡和协调能力足够完整以允许接受监督指导的情况下，才可以开始进行。临时支柱的应用需要广泛的假肢经验和极端的谨慎。
