Fitzpatrick Noel, Smith Thomas J, Pendegrass Catherine J, Yeadon Russell, Ring Michael, Goodship Allen E, Blunn Gordon W
Fitzpatrick Referrals, Eashing, Surrey, UK.
Vet Surg. 2011 Dec;40(8):909-25. doi: 10.1111/j.1532-950X.2011.00891.x. Epub 2011 Nov 4.
To report clinical application of intraosseous transcutaneous amputation prosthesis (ITAP) for limb salvage.
Retrospective case series.
Client owned dogs with malignant neoplasia of the distal aspect of the limb.
Distal limb amputation allowed press-fit insertion of the ITAP into the radius (n = 3) or tibia (1). Remaining soft tissues including skin were attached directly to the ITAP. Limb stump and ITAP were protected by bandaging (1) or external skeletal fixation (3) for 5-6 weeks before exoprosthesis attachment. Measures of outcome included subjective assessments of limb function by owners and veterinarians, radiographic (4) and histologic (1) examination.
Dermal integration with the ITAP was achieved by 3 weeks and dogs were walking in a pain-free manner by 8 weeks. One dog was administered adjunctive carboplatin chemotherapy. No evidence of local tumor recurrence occurred. In 1 dog, ITAP fracture occurred at 10 weeks and was successfully managed by ITAP replacement. Three dogs were euthanatized because of confirmed or assumed metastatic disease at 8, 12, and 17 months. Histologic examination of the ITAP-limb interface at 1 year documented osseous and dermal integration.
Implantation of ITAP to the distal limb of dogs is feasible and can result in favorable functional outcomes. Biological integration of osseous and dermal tissues with ITAP is reliable and robust.
报告经皮骨内截肢假体（ITAP）用于肢体挽救的临床应用。
回顾性病例系列。
患有肢体远端恶性肿瘤的宠物犬。
对肢体远端进行截肢，将ITAP压配合插入桡骨（n = 3）或胫骨（1例）。包括皮肤在内的剩余软组织直接附着于ITAP。在安装外部假体之前，肢体残端和ITAP通过绷带包扎（1例）或外骨骼固定（3例）保护5 - 6周。观察指标包括主人和兽医对肢体功能的主观评估、影像学检查（4例）和组织学检查（1例）。
3周时实现了皮肤与ITAP的整合，8周时犬能无痛行走。1只犬接受了辅助性卡铂化疗。无局部肿瘤复发迹象。1只犬在10周时发生ITAP骨折，通过更换ITAP成功处理。3只犬因在8、12和17个月时确诊或疑似发生转移性疾病而实施安乐死。1年时对ITAP - 肢体界面进行组织学检查，证实了骨和皮肤的整合。
将ITAP植入犬的肢体远端是可行的，并且可产生良好的功能结果。骨和皮肤组织与ITAP的生物整合可靠且稳固。
