Thorpe W, Gerber L H, Lampert M, Reed J, Sabel I
Clin Orthop Relat Res. 1979 Sep(143):133-7.
Twenty-four above-knee amputees (AKA) treated with rigid plaster dressings were randomized to receive ambulation on pylon within 24 hours of surgery or at time of suture removal. Casts were applied by physical therapists in half of each group, and by a prosthesist in the other half. There were no statistically significant differences among the groups with respect to age, sex, stump length, gait characteristics and wound healing. Time to prescription of final prosthetis was similar in all groups. Specifically, there was no delay in the group ambulated immediately. The immediate ambulators did have significantly greater stump pain requiring more analgesia than the group ambulated after suture removal. Patients with case applied by physical therapists used their prostheses more than patients with cases applied by prosthetists. There was no detectable difference among treatment groups with regard to participation in therapy, acceptance of prosthesis, and psychological status. Recommendation for management of AKA's include: use of rigid dressing; ambulation on pylon after suture removal; utilization of physical therapist for application of rigid dressings and alignment of pylon.
24名接受硬石膏敷料治疗的膝上截肢者被随机分为两组，一组在术后24小时内使用假肢行走，另一组在拆线时使用假肢行走。每组中一半的石膏由物理治疗师应用，另一半由假肢师应用。在年龄、性别、残肢长度、步态特征和伤口愈合方面，两组之间没有统计学上的显著差异。所有组中最终假肢处方的时间相似。具体而言，立即行走组没有延迟。与拆线后行走组相比，立即行走组的残肢疼痛明显更严重，需要更多的镇痛药物。由物理治疗师应用石膏的患者比由假肢师应用石膏的患者更多地使用假肢。在治疗参与度、假肢接受度和心理状态方面，各治疗组之间没有可检测到的差异。对膝上截肢者的管理建议包括：使用硬敷料；拆线后使用假肢行走；利用物理治疗师应用硬敷料和调整假肢。
