全骨盆切除后胸廓承重接受腔和交互步态行走假肢适配1例报道

Thoracic-weight-bearing Socket and Reciprocating Gait Prosthesis for Pelvis Disarticulation Amputee:A Case Report

目的探讨全骨盆切除术后胸廓承重接受腔和交互步态行走假肢的设计、装配和使用方法。方法报道1例全骨盆切除术后患者。接受腔主要承重部位在下胸廓,悬吊依靠接受腔前后方向作用力,行走假肢由接受腔、交互步态行走矫形器的髋关节、假肢膝关节和SACH假脚组成,调节对线,进行步行训练。结果患者借助接受腔直立每次可达4 h,借助腋拐可使用假肢以交互步态连续行走200 m,耗时30 min。改良Barthel指数评分由入院时的41.5分提高到出院时的93分(使用接受腔)和83分(使用假肢)。结论合理选择接受腔的受力位置、悬吊方式可以实现全骨盆切除者直立,合理选择假肢部件、正确力线和步行训练可以实现借助腋拐交互步态行走,从而提高日常生活活动能力。

Objective To design,fit and use a thoracic-weight-bearing socket and reciprocating gait prosthesis for amputee pelvis disarticulation.Methods A case after pelvis disarticulation amputation was reported.The main weight of the socket bore on lower thorax,and the socket suspended with the pressure from anterior-posterior sides.Walking prosthesis was consisted of the socket,reciprocating hip joint,prosthetic knee joint and SACH foot.The prosthesis was adjusted alignment,and the patient was trained to walk with the prosthesis.Results The patient could stand for four hours a time with the socket,and walk 200 meters in 30 minutes assisted with axillary crutches.The score of modified Barthel Index improved from 41.5 admitted to hospital to 93(with socket)or 83(with prosthesis)as discharged.Conclusion Pelvis disarticulation amputees could stand up with socket with reasonable weight bearing and suspension and walk in reciprocating gait with reasonable components and joints,right alignment and gait training,to improve activities of daily living.