Karakoç Mehmet, Batmaz İbrahim, Sariyildiz Mustafa Akif, Yazmalar Levent, Aydin Abdülkadir, Em Serda
From the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey (MK, İB, MAS, LY, SE); and Vocational School of Atatürk Health Services, Dicle University, Diyarbakir, Turkey (AA).
Am J Phys Med Rehabil. 2017 Aug;96(8):578-581. doi: 10.1097/PHM.0000000000000689.
Patients with amputation need prosthesis to comfortably move around. One of the most important parts of a good prosthesis is the socket. Currently, the most commonly used method is the traditional socket manufacturing method, which involves manual work; however, computer-aided design/computer-aided manufacturing (CAD/CAM) is also being used in the recent years. The present study aimed to investigate the effects of sockets manufactured by traditional and CAD/CAM method on clinical characteristics and quality of life of patients with transtibial amputation.
The study included 72 patients with transtibial amputation using prosthesis, 36 of whom had CAD/CAM prosthetic sockets (group 1) and 36 had traditional prosthetic sockets (group 2). Amputation reason, prosthesis lifetime, walking time and distance with prosthesis, pain-free walking time with prosthesis, production time of the prosthesis, and adaptation time to the prosthesis were questioned. Quality of life was assessed using the 36-item Short Form Health Survey questionnaire and the Trinity Amputation and Prosthesis Experience Scales.
Walking time and distance and pain-free walking time with prosthesis were significantly better in group 1 than those in group 2. Furthermore, the prosthesis was applied in a significantly shorter time, and socket adaptation time was significantly shorter in group 1. Except emotional role limitation, all 36-item Short Form Healthy Survey questionnaire parameters were significantly better in group 1 than in group 2. Trinity Amputation and Prosthesis Experience Scales activity limitation scores of group 1 were lower, and Trinity Amputation and Prosthesis Experience Scales satisfaction with the prosthesis scores were higher than those in group 2.
Our study demonstrated that the sockets manufactured by CAD/CAM methods yield better outcomes in quality of life of patients with transtibial amputation than the sockets manufactured by the traditional method.
截肢患者需要假肢才能舒适地四处活动。优质假肢最重要的部件之一是接受腔。目前，最常用的方法是传统的接受腔制造方法，该方法涉及手工操作；然而，近年来计算机辅助设计/计算机辅助制造（CAD/CAM）也被投入使用。本研究旨在探讨传统方法和CAD/CAM方法制造的接受腔对胫部截肢患者临床特征和生活质量的影响。
该研究纳入了72名使用假肢的胫部截肢患者，其中36名使用CAD/CAM假肢接受腔（第1组），36名使用传统假肢接受腔（第2组）。询问了截肢原因、假肢使用寿命、佩戴假肢的行走时间和距离、佩戴假肢无痛行走时间、假肢制作时间以及适应假肢的时间。使用36项简短健康调查问卷和三位一体截肢与假肢体验量表评估生活质量。
第1组佩戴假肢的行走时间和距离以及无痛行走时间明显优于第2组。此外，第1组应用假肢的时间明显更短，接受腔适应时间也明显更短。除情感角色限制外，第1组的所有36项简短健康调查问卷参数均明显优于第2组。第1组的三位一体截肢与假肢体验量表活动限制得分较低，三位一体截肢与假肢体验量表对假肢的满意度得分高于第2组。
我们的研究表明，与传统方法制造的接受腔相比，CAD/CAM方法制造的接受腔在胫部截肢患者的生活质量方面产生了更好的效果。
