Lilja M, Hoffmann P, Oberg T
Department of Biomechanics and Orthopaedic Technology, University College of Health Sciences, Jönköping, Sweden.
Prosthet Orthot Int. 1998 Aug;22(2):115-22. doi: 10.3109/03093649809164472.
Morphological changes in the amputation stump may have serious implications regarding the suspension and fit of the prosthetic socket. In an earlier study (Lilja and Oberg, 1997) the authors have shown that the volume of the trans-tibial amputation stump decreases according to a negative power function after amputation, and that the stump volume does not stabilise until four months after the operation. In the present study, Magnetic Resonance Imaging (MRI) technique was used to examine morphological changes in the amputation stump after trans-tibial amputation in a small number of cases. The authors expected to find a decrease in the cross-sectional area of the stump and of the separate muscles similar to the findings in earlier studies. However, two different patterns were found. The cross-sectional area of the entire stump as well as that of the medial muscle group changed according to the authors' hypothesis, i.e. an initial fast decrease, followed by a more moderate decrease of the area. In the lateral muscle group another pattern was found. After an initial rapid decrease the area increased, sometimes to a magnitude larger than the initial value. After the amputation the lateral muscle group may acquire a new function, contributing to the suspension of the socket. Despite the limited number of patients, this study presents findings which may be important in the clinical fitting of trans-tibial prostheses.
截肢残端的形态变化可能对假肢接受腔的悬吊和适配产生严重影响。在早期的一项研究中（Lilja和Oberg，1997年），作者表明，截肢后经胫骨截肢残端的体积按照负幂函数减小，并且残端体积直到手术后四个月才稳定下来。在本研究中，使用磁共振成像（MRI）技术在少数病例中检查了经胫骨截肢后截肢残端的形态变化。作者预计会发现残端和各单独肌肉的横截面积减小，类似于早期研究中的发现。然而，发现了两种不同的模式。整个残端以及内侧肌肉群的横截面积按照作者的假设变化，即最初快速减小，随后面积减小更为平缓。在外侧肌肉群中发现了另一种模式。在最初快速减小之后，面积增加，有时增加到大于初始值的程度。截肢后，外侧肌肉群可能获得新的功能，有助于接受腔的悬吊。尽管患者数量有限，但本研究呈现的结果可能对经胫骨假肢的临床适配具有重要意义。
