Kelle Bayram, Kozanoğlu Erkan, Biçer Ömer Sunkar, Tan İsmet
Cukurova University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana, Turkey.
Cukurova University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana, Turkey.
Acta Orthop Traumatol Turc. 2017 Mar;51(2):142-145. doi: 10.1016/j.aott.2017.02.007. Epub 2017 Feb 27.
The aim of this study was to evaluate the natural course of phantom limb complex without any treatment after lower limb amputation.
The study design was consisted of a combination of retrospective review and cross-sectional interview. 101 patients with lower limb amputation were included into the study. Patients were divided into three groups according to the amputation level: i) from hip disarticulation to knee disarticulation (including knee disarticulation) (25 patients, mean age: 55.9, 19 males, 6 females) ii) transtibial amputation (below knee to ankle including ankle disarticulation) (41 patients, mean age: 58.6, 33 males, 8 females) iii) below ankle to toe amputation (35 patients, mean age: 58.7, 26 males, 9 females). The patients were evaluated on both early postoperative period (EPP) and sixth months after the surgery (ASM). The data related amputation including amputation date, level, cause, stump pain (SP), phantom limb pain (PLP), components of PLP, phantom sensation (PS) were recorded based on the information obtained from patients' and hospital files.
Statistically significant differences were found for pain intensity (VAS) between groups for SP and PLP at EPP (p < 0.001, p = 0.036; respectively). The mean VAS score in Group I for SP and PLP was higher than other groups. This differences for SP and PLP did not continue at ASM assessment (p = 0.242, p = 0.580; respectively).
VAS scores for SP in above knee amputations and VAS scores for PLP in above knee amputations and below ankle amputations were higher at EPP. But these high scores had disappeared over time. Management strategies have to be considered particularly in the early postoperative period in patients who had undergone above knee amputation.
Level III Prognostic study.
本研究旨在评估下肢截肢后未经任何治疗的幻肢综合征的自然病程。
研究设计包括回顾性分析和横断面访谈。101例下肢截肢患者纳入研究。根据截肢水平将患者分为三组：i）从髋关节离断至膝关节离断（包括膝关节离断）（25例，平均年龄：55.9岁，男性19例，女性6例）；ii）经胫骨截肢（膝关节以下至踝关节，包括踝关节离断）（41例，平均年龄：58.6岁，男性33例，女性8例）；iii）踝关节以下至趾部截肢（35例，平均年龄：58.7岁，男性26例，女性9例）。在术后早期（EPP）和术后六个月（ASM）对患者进行评估。根据从患者和医院档案中获得的信息，记录与截肢相关的数据，包括截肢日期、水平、原因、残端疼痛（SP）、幻肢痛（PLP）、PLP的组成部分、幻肢感觉（PS）。
在EPP时，三组患者的SP和PLP疼痛强度（VAS）差异有统计学意义（分别为p < 0.001，p = 0.036）。I组SP和PLP的平均VAS评分高于其他组。在ASM评估时，SP和PLP的这些差异未持续存在（分别为p = 0.242，p = 0.580）。
在EPP时，膝上截肢患者的SP的VAS评分以及膝上截肢和踝关节以下截肢患者的PLP的VAS评分较高。但这些高分随时间消失。对于膝上截肢患者，尤其在术后早期必须考虑管理策略。
III级预后研究。
