Khan Atif A, Çarlı Alparslan B, Akhlaque Uzma, Kara Murat, Waheed Akhtar, Özçakar Levent
Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan.
Saglik Bilimleri University, Sultan Abdulhamit Han Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.
Foot Ankle Surg. 2018 Dec;24(6):506-508. doi: 10.1016/j.fas.2017.05.012. Epub 2017 Jun 12.
Unilateral lower limb amputation can alter the tissue morphology leading to increase future risk of degenerative secondary disorders.
Thirty-four consecutive male patients with unilateral lower limb amputations of different levels and 34 well matched male controls were included. To explore whether the ankles of traumatic lower limb amputees were undergoing morphological changes, three different tissue types i.e. talar cartilage, plantar fascia and Achilles tendon thicknesses in the intact limb of the lower limb amputee and healthy controls were measured by using ultrasound.
Plantar fascia was found to be thicker (p=0.013) and talar cartilage was thinner (p<0.001) on the intact sides of the patients than those of the controls. Achilles tendon thickness was found to be similar. In patients group, plantar fascia thickness was positively correlated with age (r=0.601, p<0.001), BMI (r=0.454, p=0.007) and durations of amputation (r=0.443, p=0.009) and prosthetic use (r=0.429, p=0.011). Achilles tendon thickness was positively correlated with durations of amputation (r=0.338, p=0.05) and prosthetic use (r=0.468, p=0.005). In controls group, talar cartilage thickness was negatively correlated with age (r=-0.640, p<0.001) and BMI (r=-0.401, p=0.019).
The talar cartilage seemed to be thinner and the plantar fascia to be thicker on the intact sides of the unilateral limb amputees.
单侧下肢截肢会改变组织形态，增加未来发生退行性继发性疾病的风险。
纳入34例不同水平单侧下肢截肢的男性患者及34例匹配良好的男性对照。为探究创伤性下肢截肢患者的踝关节是否发生形态变化，采用超声测量下肢截肢患者健侧肢体和健康对照的三种不同组织类型，即距骨软骨、足底筋膜和跟腱厚度。
发现患者健侧的足底筋膜更厚（p = 0.013），距骨软骨更薄（p < 0.001），而跟腱厚度相似。在患者组中，足底筋膜厚度与年龄（r = 0.601，p < 0.001）、体重指数（r = 0.454，p = 0.007）、截肢持续时间（r = 0.443，p = 0.009）和假肢使用时间（r = 0.429，p = 0.011）呈正相关。跟腱厚度与截肢持续时间（r = 0.338，p = 0.05）和假肢使用时间（r = 0.468，p = 0.005）呈正相关。在对照组中，距骨软骨厚度与年龄（r = -0.640，p < 0.001）和体重指数（r = -0.401，p = 0.019）呈负相关。
单侧肢体截肢患者健侧的距骨软骨似乎更薄，足底筋膜更厚。
