1University of Novi Sad, Novi Sad Faculty of Medicine, Novi Sad, Serbia; 2Department of Vascular and Endovascular Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia; 3Medical Rehabilitation Department, Clinical Center of Vojvodina, Novi Sad, Serbia.
Acta Clin Croat. 2021 Dec;60(4):657-664. doi: 10.20471/acc.2021.60.04.13.
Lower extremity amputation is a very common amputation and successful prosthetic rehabilitation is a desirable outcome. The aim of this study was to determine which factors affect the success of prosthetic rehabilitation after transtibial vascular amputation. The study included 61 patients who had undergone transtibial amputation (mean age, 64.2±10.4 years; 50 (82%) males). Patients who were able to walk at least 45 meters without aids or with only one walking stick after rehabilitation program were classified into the group of successful prosthetic users. Age, gender, comorbidities, patency of the popliteal artery, wound healing complications, and presence of the phantom limb pain were used as predictive variables. Multivariate logistic regression analysis was used to identify predictive factors of successful prosthetic rehabilitation. The model included all variables explaining up to 59.8% of variance, however, only age, absence of functional patency of the popliteal artery and compromised wound healing made significant contribution to the model. In conclusion, good general condition of the patient and sustained patency of the popliteal artery reliably led to clinical improvement and realization of full capacity of rehabilitation after below-knee amputation.
下肢截肢是一种非常常见的截肢手术,成功的假肢康复是理想的结果。本研究旨在确定哪些因素会影响经胫骨血管截肢后假肢康复的成功。该研究纳入了 61 名接受经胫骨截肢的患者(平均年龄为 64.2±10.4 岁;50 名男性(82%))。康复计划后,能够至少在没有辅助器具或仅使用一根拐杖的情况下行走 45 米的患者被归类为成功的假肢使用者。年龄、性别、合并症、腘动脉通畅性、伤口愈合并发症和幻肢痛的存在被用作预测变量。采用多变量逻辑回归分析来确定假肢康复成功的预测因素。该模型包括解释高达 59.8%方差的所有变量,但只有年龄、腘动脉无功能通畅性和伤口愈合受损对模型有显著贡献。总之,患者良好的一般状况和持续的腘动脉通畅性可靠地导致了临床改善,并在膝下截肢后实现了康复的全部能力。