Glapa K, Hoffmann R, Greitemann B
BG-Unfallklinik Frankfurt, Friedberger Landstraße 430, 60389, Frankfurt, Deutschland.
Klinik Münsterland, Auf der Stöwwe 11, 49214, Bad Rothenfelde, Deutschland.
Orthopade. 2021 Jan;50(1):24-31. doi: 10.1007/s00132-020-04039-8.
Problems in prosthetic fitting or mobility of amputated patients are often caused primarily by insufficient stump quality. To achieve better rehabilitation results and a higher quality of life it is mandatory that the physician treating the patient is able to diagnose stump problems and to indicate stump correction surgery. A skilled knowledge of amputation techniques, different levels of amputation, as well as of prosthetic fitting methods is needed. The physician has to have knowledge of the differences between phantom sensation, phantom pain and stump pain, as well as their possible causes. Especially with stump pain caused by stump problems revision surgery has to be considered with the patient. A well-done surgical stump correction should result in a better end-bearing capacity, less pain, improved rehabilitation potential and better life quality. Stump revision surgery should be indicated more often, and this type of surgery should be a standard procedure in every orthopaedic and trauma department.
截肢患者在假肢适配或活动方面的问题通常主要是由残肢质量不足引起的。为了获得更好的康复效果和更高的生活质量,治疗患者的医生必须能够诊断残肢问题并指明残肢矫正手术。需要熟练掌握截肢技术、不同截肢水平以及假肢适配方法的知识。医生必须了解幻肢感觉、幻肢痛和残肢痛之间的区别及其可能的原因。特别是对于由残肢问题引起的残肢痛,必须与患者商讨翻修手术。精心实施的手术残肢矫正应能带来更好的末端承重能力、更少的疼痛、改善的康复潜力和更好的生活质量。残肢翻修手术应更频繁地进行,并且这种手术应成为每个骨科和创伤科的标准程序。