Wada Yoshitaka, Masaoka Tomokazu, Morotomi Nobuo, Kawate Nobuyuki
Department of Rehabilitation Medicine, Showa University Fujigaoka Rehabilitation Hospital, Kanagawa, Japan.
Prog Rehabil Med. 2021 Jan 27;6:20210004. doi: 10.2490/prm.20210004. eCollection 2021.
Pirogoff amputation is a calcaneal amputation invented by Nicolás Pirogoff that involves partial preservation of the calcaneus.
A 59-year-old woman was diagnosed with left Lisfranc and Chopart joint fracture-dislocation 9 months after a fall. The patient underwent debridement together with Pirogoff amputation and surgery to place an Ilizarov external fixator. Five months later, the patient was transferred to a rehabilitation hospital. Because of inadequate bone fusion, for 3 months after the amputation the patient underwent gait training with a patellar tendon weight-bearing orthosis to avoid loading the amputated side. After fusion of the bone, the patient was able to walk using a Syme prosthesis and a cane. Three months after discharge from the rehabilitation hospital, the patient was diagnosed with hallux osteomyelitis of the other foot that was associated with the exacerbation of hallux valgus. The patient underwent hallux correction surgery. Three and a half months after the second hospital admission, the patient was again admitted to the rehabilitation hospital. At the end of the rehabilitation program, the patient was able to walk using a cane and a prosthesis.
Appropriate orthotic treatment and care of the non-amputated limb are of great importance in patients who have undergone a partial foot amputation.
皮罗戈夫截肢术是尼古拉斯·皮罗戈夫发明的一种跟骨截肢术，涉及跟骨的部分保留。
一名59岁女性在跌倒9个月后被诊断为左利斯弗朗和乔帕特关节骨折脱位。患者接受了清创术以及皮罗戈夫截肢术，并进行了伊里扎洛夫外固定架置入手术。5个月后，患者转至康复医院。由于骨融合不充分，截肢术后3个月患者使用髌腱承重矫形器进行步态训练，以避免患侧负重。骨融合后，患者能够使用赛姆假肢和拐杖行走。从康复医院出院3个月后，患者被诊断出另一只脚患有拇趾骨髓炎，与拇外翻加重有关。患者接受了拇趾矫正手术。第二次入院3个半月后，患者再次入住康复医院。在康复计划结束时，患者能够使用拐杖和假肢行走。
对于接受部分足部截肢的患者，对非截肢肢体进行适当的矫形治疗和护理非常重要。
