Schwitalle M, Brückner L
Orthopädische Universitätsklinik Mainz.
Zentralbl Chir. 1998;123(3):235-8.
The present study aims to evaluate early and late results after standardized below-knee amputation according to Brückner in vascular patients.
During the period 1982 to 1989 72 patients with occlusive arterial disease stage IV underwent below-knee amputation at an average age of 69.7 years. 38 of the amputees could be re-investigated at the end of 1991 after an average follow-up of 5.3 years. Evaluation criteria consisted of wound healing, knee joint preservation, prosthetic fitting, stump appearance, gait capacity or ambulation, the need for assistance by another person and patients own valuation. Accordingly, rehabilitation level was classified to be good, satisfying or dissatisfying.
Knee joint preservation rate amounted to 91.7% (66 patients). Postsurgical prosthetic fitting could be achieved in 55 amputees (76.4%). All the 38 re-investigated stumps were inapparent. 27 of the patients (71.1%) showed good and 7 patients (18.4%) satisfying rehabilitation, whereas the rehabilitation level was dissatisfying in 4 cases (10.5%). This objective evaluation was affirmed by patients own estimation: 33 amputees (86.6%) would again agree to the operation.
Early as well as late results in this series indicate that the standardized below-knee amputation according to Brückner promises high rates of healing, knee joint preservation and thus successful rehabilitation in patients with occlusive arterial disease.
本研究旨在评估血管疾病患者按照布吕克纳方法进行标准化膝下截肢后的早期和晚期效果。
1982年至1989年期间，72例IV期闭塞性动脉疾病患者接受了膝下截肢，平均年龄69.7岁。1991年底，对其中38例截肢者进行了复查，平均随访5.3年。评估标准包括伤口愈合情况、膝关节保留情况、假肢适配情况、残端外观、步态能力或行走情况、是否需要他人协助以及患者自身评价。据此，将康复水平分为良好、满意或不满意。
膝关节保留率为91.7%（66例患者）。55例截肢者（76.4%）术后能够适配假肢。所有38例接受复查的残端外观均不明显。27例患者（71.1%）康复情况良好，7例患者（18.4%）康复情况满意，4例患者（10.5%）康复水平不满意。患者自身评价证实了这一客观评估结果：33例截肢者（86.6%）表示愿意再次接受该手术。
本系列研究的早期和晚期结果均表明，按照布吕克纳方法进行的标准化膝下截肢在闭塞性动脉疾病患者中具有较高的愈合率、膝关节保留率，从而能够实现成功康复。
