Department of Physical Medicine and Rehabilitation, Haydarpaşa Training Hospital, Gülhane Military Medical Academy, Istanbul, Turkey.
PM R. 2013 Jul;5(7):591-5. doi: 10.1016/j.pmrj.2013.01.013. Epub 2013 Feb 9.
Landmine injuries cause extensive soft and bony tissue loss of the weight-bearing areas, particularly the heel. Reconstruction of these injuries is challenging, and there are no studies that report long-term functional results.
To determine the quality of life and long-term functionality of patients who had heel reconstruction with free muscle flap after landmine injuries.
A case-control study.
Nine male patients who had heel reconstruction with free muscle flap. Ten male volunteers without any gait disorder were included in the study as the control group.
Functional ambulation scale, visual analog scale, energy expenditure index, 6-minute walking test, 10-m walking test, and Short Form 36 were performed to determine the quality of life and functionality of the participants.
There were no statistically significant differences between the 2 groups in terms of functional ambulation scale, energy expenditure index, 6-minute walking test, and 10-m walking test. Regarding Short Form 36 scores, all subgroup values were lower in the reconstruction group, whereas only those of general health, vitality, and physical-emotional role limitation subgroups showed statistical significance. Mean visual analog scale scores were found to be statistically different between the groups (P < .05). Mean Freiburg Ankle scores showed moderate functionality.
Despite the associated physical and emotional trauma, combat-injured veterans with heel reconstruction after landmine injuries had adequate and functional ambulation at long-term follow-up. Early rehabilitation and close cooperation between surgeons and rehabilitation physicians during the care of these patients will enhance patient outcomes.
地雷伤会导致承重区域(尤其是足跟)广泛的软、硬组织缺失。重建这些损伤具有挑战性,目前尚无研究报告其长期功能结果。
确定足跟重建后采用游离肌肉皮瓣重建的地雷伤患者的生活质量和长期功能。
病例对照研究。
9 名男性地雷伤患者,均采用游离肌肉皮瓣进行足跟重建。10 名男性志愿者无任何步态障碍,纳入本研究作为对照组。
采用功能步行量表、视觉模拟量表、能量消耗指数、6 分钟步行试验、10 米步行试验和健康调查简表 36 项版来确定参与者的生活质量和功能。
在功能步行量表、能量消耗指数、6 分钟步行试验和 10 米步行试验方面,两组间无统计学差异。在健康调查简表 36 项版评分方面,重建组所有亚组评分均较低,而仅一般健康、活力和身体-情绪角色限制亚组评分有统计学意义。两组间平均视觉模拟量表评分存在统计学差异(P<.05)。平均弗赖堡踝关节评分显示功能为中度。
尽管存在身体和情绪创伤,足跟重建后采用游离肌肉皮瓣重建的地雷伤退伍军人在长期随访时仍具有足够和功能性的步行能力。早期康复以及在这些患者治疗过程中外科医生和康复医师之间的密切合作将改善患者结局。