Santi M D, Thoma B J, Chambers R B
Ortho-Diabetes Service, Rancho Los Amigos Medical Center, Downey, California.
Clin Orthop Relat Res. 1993 Jul(292):245-9.
The results of 94 initially successful, partial foot amputations in dysvascular patients were reviewed with survivorship analysis at a minimum of 6.5 years after surgery. Partial foot amputations were divided into three types: transmetatarsal amputations, metatarsophalangeal disarticulations, and ray resections. No amputation type was more or less likely to be treated with subsequent amputation of the foot or to develop recurrent ulceration. Taking all groups together, the chance of retaining the foot after an initially healed partial foot amputation was 86% at four years after operation and 76% at eight years after operation. Of these surviving feet, however, 53.8% developed ulceration or needed local reoperation. The chance of completely avoiding any surgery after an initially healed partial foot amputation was 71% at four years after operation and 52% at eight years after operation. In properly selected patients, partial foot amputations have significant longevity.
对94例血管病变患者最初成功的部分足部截肢手术结果进行了回顾,采用生存分析,随访时间至少为术后6.5年。部分足部截肢分为三种类型:经跖骨截肢、跖趾关节离断和射线切除。没有哪种截肢类型接受后续足部截肢治疗或发生复发性溃疡的可能性更高或更低。综合所有组来看,最初愈合的部分足部截肢术后四年保留足部的几率为86%,术后八年为76%。然而,在这些存活的足部中,53.8%出现了溃疡或需要局部再次手术。最初愈合的部分足部截肢术后四年完全避免任何手术的几率为71%,术后八年为52%。在经过适当选择的患者中,部分足部截肢具有显著的长期效果。