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犬类部分肢体套接式假肢的回顾性多中心分析

Retrospective Multi-Center Analysis of Canine Socket Prostheses for Partial Limbs.

作者信息

Wendland Theresa M, Seguin Bernard, Duerr Felix M

机构信息

Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.

出版信息

Front Vet Sci. 2019 Apr 5;6:100. doi: 10.3389/fvets.2019.00100. eCollection 2019.

Abstract

Socket prostheses for treatment of distal limb pathology are becoming increasingly prevalent in veterinary medicine, however, limited objective data is available. Objectives of the present study were to retrospectively evaluate owner satisfaction, clinical outcomes, and prognostic factors associated with dogs receiving socket prostheses for partial limbs in a larger patient population. Client databases of a single prosthesis provider were reviewed to identify owners whose dogs had received a prosthetic device within the last 10 years. An online survey was developed to evaluate owner-reported outcomes. The survey inquired about anatomy of the residuum, concurrent disease, prosthesis use, rehabilitation, activity, complications, and owner satisfaction. Medical records and radiographs were requested from all participants. Radiographs were used to confirm level of amputation and evaluate for osseous complications. Survey responses were analyzed by assigning author-defined numeric scores defining clinical outcome and owner satisfaction. One-hundred thirty-seven owners were contacted. The response rate was 50/137 (37%); 47 responses were analyzed. Forty-six of 47 owners reported positive satisfaction; 1/47 was displeased. Forty-two of 47 dogs were scored to have acceptable to full function; 5/47 had unacceptable clinical function using the author-defined scoring system. A 62% short-term complication rate and a 19% long-term complication rate were reported. Skin sores were the most common short and long-term complication. There was a significant correlation between both clinical outcome scores and owner satisfaction with days per week spent in the prosthesis. Additionally, clinical outcome scores and owner satisfaction significantly varied between dogs with different durations of prosthesis wear with a trend toward better outcomes associated with longer prosthesis wear. Radiographs were obtained for 23/47 dogs to further define level of defect. The most proximal level of defect was mid-radius for the forelimb and mid-tibia for the hind limb. There was no correlation between level of defect and either owner satisfaction or clinical outcome. Results of this survey suggest a high degree of owner satisfaction despite substantial complication rates. Based on preliminary data, further evaluation of socket prostheses as a limb-sparing option for treatment of distal limb pathology should be considered. Prospective clinical trials with objective outcome measures are required to draw firm conclusions.

摘要

用于治疗远端肢体疾病的套接式假肢在兽医学中越来越普遍,然而,可用的客观数据有限。本研究的目的是回顾性评估在更大的患者群体中接受部分肢体套接式假肢的犬只的主人满意度、临床结果和预后因素。回顾了单一假肢供应商的客户数据库,以确定其犬只在过去10年内接受过假肢装置的主人。开发了一项在线调查来评估主人报告的结果。该调查询问了残肢的解剖结构、并发疾病、假肢使用情况、康复情况、活动情况、并发症以及主人满意度。要求所有参与者提供病历和X光片。X光片用于确认截肢水平并评估骨并发症。通过分配作者定义的数字分数来分析调查回复,这些分数定义了临床结果和主人满意度。联系了137位主人。回复率为50/137(37%);分析了47份回复。47位主人中有46位报告了积极的满意度;1/47不满意。47只犬中有42只根据作者定义的评分系统被评为功能可接受至完全功能;5/47的临床功能不可接受。报告的短期并发症发生率为62%,长期并发症发生率为19%。皮肤溃疡是最常见的短期和长期并发症。临床结果评分和主人满意度与每周使用假肢的天数之间存在显著相关性。此外,不同假肢佩戴时间的犬只之间临床结果评分和主人满意度存在显著差异,且有趋势表明假肢佩戴时间越长结果越好。为47只犬中的23只获取了X光片以进一步确定缺损水平。前肢最近端的缺损水平为桡骨中部,后肢为胫骨中部。缺损水平与主人满意度或临床结果之间没有相关性。这项调查的结果表明,尽管并发症发生率较高,但主人满意度较高。基于初步数据,应考虑进一步评估套接式假肢作为治疗远端肢体疾病的保肢选择。需要进行具有客观结果指标的前瞻性临床试验才能得出确凿结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff80/6460115/1fafa76475fb/fvets-06-00100-g0001.jpg

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