Seiler S, Stirnemann P
Klinik für Thorax-, Herz- und Gefässchirurgie, Universität Bern.
Vasa. 1995;24(4):368-72.
During the last five years 54 patients (mean age 69 years) have undergone a unilateral, transgenicular (through-knee) amputation, instead of an impending amputation through the thigh. The indication for surgery was a chronic, or an acute critical ischemia of the leg. In 32 and 22 cases respectively, amputations have been preceded by a multitude of reconstructive measures. Uncomplicated stump healing was observed in 25 of 51 survivors (49%). Disturbances in the wound healing process necessitated further amputation in 26 cases (51%). In 13 of these cases the advantage of the transgenicular amputation could be retained by a partial femoral condylectomy, whereas in the other 13 cases a thigh amputation was inavoidable. Thus, in three out of four of the survivors, a long, strong stump with a good terminal load-carrying capacity could be retained which, when supplied by a prosthesis, led to the recovery of the original walking ability in 90% of these cases.
在过去五年中,54例患者(平均年龄69岁)接受了单侧经膝关节截肢手术,而非即将进行的大腿截肢手术。手术指征为腿部慢性或急性严重缺血。分别有32例和22例在截肢前采取了多种重建措施。51名幸存者中有25例(49%)伤口愈合顺利。26例(51%)伤口愈合过程出现问题,需要进一步截肢。其中13例通过部分股骨髁切除术保留了经膝关节截肢的优势,而另外13例则不可避免地进行了大腿截肢。因此,四分之三的幸存者保留了长而强壮、末端承重能力良好的残肢,配备假肢后,90%的患者恢复了原来的行走能力。