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一种保留大腿近端软组织残端的新型髋关节离断技术:病例报告

A Novel Technique of Hip Disarticulation with a Stump with Soft Tissue of the Proximal Thigh: A Case Report.

作者信息

Mizuma Tsuyoshi, Yamamoto Kazuki, Kurihara Kazutaka, Furusawa Keishi, Kamio Satoshi, Hirozane Toru, Yamaguchi Sayaka, Watanabe Rumi, Mori Tomoaki, Asano Naofumi, Nakayama Robert

机构信息

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Prosthetics and Orthotics Support Center, Tetsudo Kosaikai Foundation, Tokyo, Japan.

出版信息

JBJS Case Connect. 2025 Apr 3;15(2). doi: 10.2106/JBJS.CC.24.00478. eCollection 2025 Apr 1.

Abstract

CASE

Two women (aged 35 and 29 years) with intractable chronic knee infection of tumor prostheses opted for amputation. As only the trochanteric region could be preserved, we resected the remaining proximal femur and created a 15-cm long stump using unaffected proximal thigh soft tissue to avoid the drawbacks of ultra-high-thigh amputation and conventional hip disarticulation. Both had no contracture, could move their stump voluntarily, and ambulated using a standard transfemoral prosthesis without a pelvic belt at 4-year and 3-year follow-ups, respectively.

CONCLUSION

Our procedure might benefit patients who require ultra-high-thigh amputation, with preservation of only the femoral trochanteric region.

摘要

病例

两名女性(年龄分别为35岁和29岁),患有肿瘤假体难治性慢性膝关节感染,选择了截肢手术。由于仅转子区能够保留,我们切除了剩余的股骨近端,并利用未受影响的大腿近端软组织创建了一个15厘米长的残端,以避免超大腿截肢和传统髋关节离断术的弊端。在4年和3年的随访中,两人均无挛缩,能够自主移动残端,分别使用标准的经股骨假体且不使用骨盆带行走。

结论

我们的手术方法可能会使那些仅需保留股骨转子区的超大腿截肢患者受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e174/11964196/5425754333d6/jbjscc-15-e24.00478-g001.jpg

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本文引用的文献

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Structural changes in the thigh muscles following trans-femoral amputation.经股骨截肢术后大腿肌肉的结构变化。
Eur J Orthop Surg Traumatol. 2017 Aug;27(6):829-835. doi: 10.1007/s00590-017-1929-5. Epub 2017 Feb 21.

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