“Spare parts surgery” is well-described in the plastic surgery literature. In the setting of trauma, otherwise discarded parts can be utilized for reconstruction resulting in a superior functional and aesthetic outc...“Spare parts surgery” is well-described in the plastic surgery literature. In the setting of trauma, otherwise discarded parts can be utilized for reconstruction resulting in a superior functional and aesthetic outcome for the patient. We describe the use of spare part surgery in order to preserve a functional knee articulation in a patient undergoing amputation for compartment.展开更多
Introduction: Amputation is the removal of a body part through a bone, while disarticulation is a removal of a part through a joint. This common procedure has different causes depending on the geographical locations a...Introduction: Amputation is the removal of a body part through a bone, while disarticulation is a removal of a part through a joint. This common procedure has different causes depending on the geographical locations and cultural practices. These ranges from dead body part to malignancy. Our study focused on the profile of the amputees including the biodata, causes and the financial consequences of the procedure. Material and Methods: The case notes of all patients who had amputation from 1998-2012 (15 years) were collected and the biodata, intra-operative diagnosis, parts amputated and duration of hospital stay were retrospectively analysed. Results: One hundred and ninety six patients had various types of amputations for the duration of our study. 159 (81.12%) were males while 37 (18.88%) were females. 68 (34.69%) patients had below knee amputation. 54 (27.55%) had above knee amputation. 27 (13.78%) had above elbow amputation. 18 (9.18%) patients had below elbow amputation, while 30 (15.30%) patients had other forms of amputations. The highest number of amputees (72 patients) was within the age range of 21 - 30 yr and the least number (5 patients) was within the age range of 51 - 60 yr. The highest number of amputation (71 patients) was due to complications from by traditional bone setters intervention. Conclusion: In our study, we found that most cases were males with a mean age of 35 years and majority (34.69%) had below knee amputation, and that most cases suffered vascular occlusion leading to gangrene.展开更多
<b>Introduction:</b> Transfemoral amputation results in a prosthesis<span "=""> </span>which bears weight on the ischium. Gait disturbance,<span "=""> </s...<b>Introduction:</b> Transfemoral amputation results in a prosthesis<span "=""> </span>which bears weight on the ischium. Gait disturbance,<span "=""> </span>lack of an end-bearing<span "=""> </span><span "="">stump and discomfort in the groin from the socket even while sitting, are important issues. <b>Methods:</b> This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here</span>, we describe<span "=""> </span>a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant.<span "=""> </span>Clinical gait analysis, SF-12 and VAS were assessed pre- and post-intervention <span "="">at 6 months of follow-up. <b>Results:</b> An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21</span><span "=""> </span>m pre-op to<span "=""> </span>0.13<span "=""> </span>m post-op, and more symmetrical stride length (<span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.21<span "=""> </span>m pre-op vs. <span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.06<span "=""> </span>m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op<span "=""> </span><span "="">vs. 0.64 ± 0.02 m/s post-op). <b>Conclusion:</b> This technique reveals improvements in gait parameters in</span><span "=""> </span>a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.展开更多
A below knee amputation(BKA)requires sufficient stump length for the fitting of a modern prosthesis.In cases of trauma where the levels of injury are unpredictable,achieving sufficient stump length can be a challenge....A below knee amputation(BKA)requires sufficient stump length for the fitting of a modern prosthesis.In cases of trauma where the levels of injury are unpredictable,achieving sufficient stump length can be a challenge.We described a case report of using the Ilizarov technique for bone lengthening at the residual BKA stump for a patient who sustained a mangled limb following a road traffic accident.Using this technique,we have successfully lengthened the tibial stump adequately for a functioning prosthesis.As shown in this case,we believe that this technique could attain an excellent outcome for a selected group of patients with short residual BKA stump.展开更多
Osteomyelitis of the calcaneus can be a limb threatening diagnosis, which is typically treated with antibiotic therapy with or without partial resection of the bone. Extensive infection of the bone commonly results in...Osteomyelitis of the calcaneus can be a limb threatening diagnosis, which is typically treated with antibiotic therapy with or without partial resection of the bone. Extensive infection of the bone commonly results in limb amputation via transtibial or transfemoral amputation, which can increase morbidity and mortality. This case report involves a 29-year-old male who sustained bilateral calcaneal fracture after a fall, who developed osteomyelitis of the right calcaneus after being treated with internal/external fixation and antibiotic therapy. In order to preserve the limb total calcaneal replacement with 3D printed implant was done.展开更多
Introduction: Prosthetic limbs must be developed with proper alignment to facilitate safe and efficient gait patterns. This study aimed to identify factors impacting clinically proper gait patterns by objectively eval...Introduction: Prosthetic limbs must be developed with proper alignment to facilitate safe and efficient gait patterns. This study aimed to identify factors impacting clinically proper gait patterns by objectively evaluating them in persons with lower-limb amputations who use prosthetic limbs. Materials and Methods: This non-experimental descriptive study assessed 58 persons with amputation who used prosthetic limbs. The mechanical axis angle (MAA) of the lower limb during the heel contact, midstance, and toe-off phases and the angle between the tube and floor during the midstance phase were measured using coronal plane gait images. We also investigated whether the MAA and tube angle during the midstance phase have a multimodal distribution. In case of multimodal distributions, we tested for significant between-group differences in patient characteristics. Results: The MAA and tube angle in the coronal plane during the midstance phase had a bimodal distribution (mean 0°). There was a significant difference in the duration of prosthetic limb use between the MAA < 0° and ≥0° groups during the midstance phase. Deviations in the lower limb MAA between the heel contact and midstance phases were 3.3° ± 2.2° and 3.1° ± 2.3° for persons with lower limb amputations in the MAA Conclusions: In this study, prosthetic alignment during the midstance phase had a bimodal distribution. In both groups, deviations in the lower limb MAA were aligned to be approximately 3°.展开更多
文摘“Spare parts surgery” is well-described in the plastic surgery literature. In the setting of trauma, otherwise discarded parts can be utilized for reconstruction resulting in a superior functional and aesthetic outcome for the patient. We describe the use of spare part surgery in order to preserve a functional knee articulation in a patient undergoing amputation for compartment.
文摘Introduction: Amputation is the removal of a body part through a bone, while disarticulation is a removal of a part through a joint. This common procedure has different causes depending on the geographical locations and cultural practices. These ranges from dead body part to malignancy. Our study focused on the profile of the amputees including the biodata, causes and the financial consequences of the procedure. Material and Methods: The case notes of all patients who had amputation from 1998-2012 (15 years) were collected and the biodata, intra-operative diagnosis, parts amputated and duration of hospital stay were retrospectively analysed. Results: One hundred and ninety six patients had various types of amputations for the duration of our study. 159 (81.12%) were males while 37 (18.88%) were females. 68 (34.69%) patients had below knee amputation. 54 (27.55%) had above knee amputation. 27 (13.78%) had above elbow amputation. 18 (9.18%) patients had below elbow amputation, while 30 (15.30%) patients had other forms of amputations. The highest number of amputees (72 patients) was within the age range of 21 - 30 yr and the least number (5 patients) was within the age range of 51 - 60 yr. The highest number of amputation (71 patients) was due to complications from by traditional bone setters intervention. Conclusion: In our study, we found that most cases were males with a mean age of 35 years and majority (34.69%) had below knee amputation, and that most cases suffered vascular occlusion leading to gangrene.
文摘<b>Introduction:</b> Transfemoral amputation results in a prosthesis<span "=""> </span>which bears weight on the ischium. Gait disturbance,<span "=""> </span>lack of an end-bearing<span "=""> </span><span "="">stump and discomfort in the groin from the socket even while sitting, are important issues. <b>Methods:</b> This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here</span>, we describe<span "=""> </span>a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant.<span "=""> </span>Clinical gait analysis, SF-12 and VAS were assessed pre- and post-intervention <span "="">at 6 months of follow-up. <b>Results:</b> An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21</span><span "=""> </span>m pre-op to<span "=""> </span>0.13<span "=""> </span>m post-op, and more symmetrical stride length (<span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.21<span "=""> </span>m pre-op vs. <span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.06<span "=""> </span>m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op<span "=""> </span><span "="">vs. 0.64 ± 0.02 m/s post-op). <b>Conclusion:</b> This technique reveals improvements in gait parameters in</span><span "=""> </span>a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.
文摘A below knee amputation(BKA)requires sufficient stump length for the fitting of a modern prosthesis.In cases of trauma where the levels of injury are unpredictable,achieving sufficient stump length can be a challenge.We described a case report of using the Ilizarov technique for bone lengthening at the residual BKA stump for a patient who sustained a mangled limb following a road traffic accident.Using this technique,we have successfully lengthened the tibial stump adequately for a functioning prosthesis.As shown in this case,we believe that this technique could attain an excellent outcome for a selected group of patients with short residual BKA stump.
文摘Osteomyelitis of the calcaneus can be a limb threatening diagnosis, which is typically treated with antibiotic therapy with or without partial resection of the bone. Extensive infection of the bone commonly results in limb amputation via transtibial or transfemoral amputation, which can increase morbidity and mortality. This case report involves a 29-year-old male who sustained bilateral calcaneal fracture after a fall, who developed osteomyelitis of the right calcaneus after being treated with internal/external fixation and antibiotic therapy. In order to preserve the limb total calcaneal replacement with 3D printed implant was done.
文摘Introduction: Prosthetic limbs must be developed with proper alignment to facilitate safe and efficient gait patterns. This study aimed to identify factors impacting clinically proper gait patterns by objectively evaluating them in persons with lower-limb amputations who use prosthetic limbs. Materials and Methods: This non-experimental descriptive study assessed 58 persons with amputation who used prosthetic limbs. The mechanical axis angle (MAA) of the lower limb during the heel contact, midstance, and toe-off phases and the angle between the tube and floor during the midstance phase were measured using coronal plane gait images. We also investigated whether the MAA and tube angle during the midstance phase have a multimodal distribution. In case of multimodal distributions, we tested for significant between-group differences in patient characteristics. Results: The MAA and tube angle in the coronal plane during the midstance phase had a bimodal distribution (mean 0°). There was a significant difference in the duration of prosthetic limb use between the MAA < 0° and ≥0° groups during the midstance phase. Deviations in the lower limb MAA between the heel contact and midstance phases were 3.3° ± 2.2° and 3.1° ± 2.3° for persons with lower limb amputations in the MAA Conclusions: In this study, prosthetic alignment during the midstance phase had a bimodal distribution. In both groups, deviations in the lower limb MAA were aligned to be approximately 3°.
