Braaksma Rudwina, Dijkstra Pieter U, Geertzen Jan H B
1 Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands.
2 Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands.
Foot Ankle Int. 2018 Mar;39(3):284-291. doi: 10.1177/1071100717745313. Epub 2018 Jan 10.
In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation.
A systematic literature search was performed. Included studies went through 2 selection procedures by 2 independent assessors. Included were all studies concerning Syme amputation with patient-related outcomes.
Thirty-six studies were included for data extraction, concerning 1056 patients (238 children and 818 adults). Heel pad migration was reported in 49 of 176 (28%), skin problems in 23 of 128 (18%), and bone problems in 42 of 145 (29%) children. No reamputations were reported. All children were fitted with a prosthesis, and 62 of 90 (69%) children participated in sports. Skin problems were reported in 35 of 195 (18%), ulceration or infection in 120 of 512 (23%), residual limb pain in 46 of 181 (25%), and reamputations in 180 of 919 (20%) adults. In total, 247 of 363 (68%) adults were fitted with a prosthesis. Walking aids were used by 45 of 135 (33%) adults. Employment status was unchanged in 147 of 209 (72%) adults.
In children, no reamputations were necessary and few complications were reported, with good participation in daily life in the majority of children. In adults, more complications and reamputations were reported; nevertheless, most adult amputees became successful prosthesis users.
Therapeutic Level III, systematic review containing retrospective cohort studies.
在下肢截肢的决策过程中，了解截肢及康复后与患者相关的结局很重要。我们尚未找到针对赛姆截肢术提供此类知识的系统评价。本研究的目的是根据国际功能、残疾和健康分类（ICF）模型，对赛姆截肢术后的结局进行概述，重点关注身体结构和功能、活动及参与情况。
进行了系统的文献检索。纳入的研究由两名独立评估者经过两轮筛选程序。纳入所有涉及赛姆截肢术及与患者相关结局的研究。
纳入36项研究进行数据提取，涉及1056例患者（238例儿童和818例成人）。176例儿童中有49例（28%）报告有足跟垫移位，128例中有23例（18%）出现皮肤问题，145例中有42例（29%）存在骨骼问题。未报告再次截肢情况。所有儿童均安装了假肢，90例儿童中有62例（69%）参与体育活动。195例成人中有35例（18%）报告有皮肤问题，512例中有120例（23%）出现溃疡或感染，181例中有46例（25%）存在残肢疼痛，919例中有180例（20%）进行了再次截肢。总共363例成人中有247例（68%）安装了假肢。135例成人中有45例（33%）使用助行器。209例成人中有147例（72%）就业状况未变。
在儿童中，无需再次截肢且报告的并发症较少，大多数儿童能很好地参与日常生活。在成人中，报告的并发症和再次截肢情况较多；然而，大多数成年截肢者成功使用了假肢。
治疗性三级，包含回顾性队列研究 的系统评价。
