Frölke Jan Paul, Aschoff Horst, Van de Meent Henk, Mittlmeier Thomas
Radboudumc Center for Trauma, Reconstructive Surgery and Movement, POB 9101, 6500HB, Nijmegen, The Netherlands.
Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Germany.
Oper Orthop Traumatol. 2025 Apr;37(2):101-113. doi: 10.1007/s00064-025-00894-w. Epub 2025 Mar 14.
Fixating an arm prosthesis with a transcutaneous bone anchor provides a more comfortable and stable attachment than conventional socket-attached prosthetics. The objective is that bone anchoring will improve prosthetic usage, reduce prosthesis rejection, and aid to functions in daily life activities.
Subjects with transhumeral amputation or elbow disarticulation and insufficient functional effect of conventional socket-attached arm prostheses.
Patients with local or systemic inflammatory processes, bone metabolism disorder, active use of chemotherapeutic or immunosuppressive medications and medically unexplained pain conditions in the respective residual arm.
A cylindrical BADAL next (OTN Implants Germany, Rostock, Germany) humerus implant is transcutaneously inserted using a retrograde press-fit approach. The distal taper of the implant is connected to an adapter that serves as an abutment for the fixation of the postoperative load-set and arm prosthesis.
Postoperative pain medication according to standard guidelines for shoulder surgery. Stoma care instructions before discharge from the hospital. Progressive loading at 6 weeks postoperatively using load plates of 100 g using in a compatible load set. Installation of an external arm prosthesis as soon as the weight of the arm prosthesis is reached.
In 4 individuals with median follow-up of 11 months, implant survival was 100%, prosthetic use improved from 0 h to an average 14 h per week, and no arm prosthesis rejection occurred. On a functional level, the 4 individuals improved from 0 to 5 on the patient-reported outcome measure (PROM) 33ADL PWP. This PROM measures 33 daily activities that can or can not be carried out with the prosthesis. No adverse events were reported.
与传统的套接式假肢相比，经皮骨锚固定手臂假肢能提供更舒适、稳定的附着方式。目的是骨锚固定将改善假肢使用情况，减少假肢排斥反应，并有助于日常生活活动功能。
经肱骨截肢或肘关节离断且传统套接式手臂假肢功能效果不佳的受试者。
局部或全身有炎症过程、骨代谢紊乱、正在积极使用化疗或免疫抑制药物以及残肢存在医学上无法解释的疼痛状况的患者。
使用逆行压配法经皮插入圆柱形BADAL next（德国罗斯托克的OTN Implants公司）肱骨植入物。植入物的远端锥度连接到一个适配器，该适配器用作术后负载装置和手臂假肢固定的支座。
根据肩部手术的标准指南进行术后疼痛药物治疗。出院前进行造口护理指导。术后6周使用100克的负载板在兼容的负载装置中进行渐进性加载。一旦达到手臂假肢的重量，立即安装外部手臂假肢。
在4名平均随访11个月的个体中，植入物存活率为100%，假肢使用时间从每周0小时提高到平均14小时，且未发生手臂假肢排斥反应。在功能水平上，这4名个体在患者报告结局量表（PROM）33ADL PWP上的得分从0提高到5。该PROM衡量33项可使用或不可使用假肢进行的日常活动。未报告不良事件。
