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Surgical revision for stump problems after traumatic above-ankle amputations of the lower extremity.

Liu K, Tang T, Wang A, Cui S - BMC Musculoskelet Disord (2015)

Bottom Line: A total of 80 stumps were treated surgically.The frequency of excess soft tissue in above-knee amputation cases was higher than that in below-knee amputation (p = 0.007).There was a significant difference in the ADL scores between admission and discharge (p = 0.000).

View Article: PubMed Central - PubMed

Affiliation: School of Rehabilitation Medicine, Capital Medical University, Beijing, China. keminlqliu@sina.com.

ABSTRACT

Background: Stump problems (SPs) secondary to traumatic lower limb amputation had a crucial influence on amputees' ability to return to living and work. The purpose of this study was to investigate the surgical management strategies of the SPs after above-ankle amputation of the lower limb secondary to trauma.

Method: A cohort of clinical cases, who were troubled by SPs after above-ankle amputation following trauma, had undergone revision surgery of the stump and was analyzed retrospectively. Various factors were noted like sex, unilateral or bilateral, amputation type, and causes of trauma. Different SPs like excess soft tissue (where a considerable amount of soft tissue interposed between the rigid elements which hindered the fitting of a prosthesis), scar, ulcers, neuromas, and bone spurs were taken as dependent variables. The relationship between factors and SPs was analyzed.

Results: A total of 80 stumps were treated surgically. The frequency of excess soft tissue in above-knee amputation cases was higher than that in below-knee amputation (p = 0.007). Bone spur occurred more frequently in the unilateral amputation than in bilateral ones (p = 0.018). There was a significant difference in the ADL scores between admission and discharge (p = 0.000).

Conclusion: Stump problems secondary to traumatic lower limb amputation had crucial influence on amputees' ability to return to living and work, appropriate evaluation and timely surgical revision showed excellent results.

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Related in: MedlinePlus

The synostosis of tibia and fibula was achieved using Ertl’s technique with the formation of a bone bridge.
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Fig4: The synostosis of tibia and fibula was achieved using Ertl’s technique with the formation of a bone bridge.

Mentions: If there was a longer and prominent fibula in the residual lower leg, an osteoplastic procedure was performed, that has been well documented in previous reports [3-7]. After the fibular shortening, the opposite surfaces of the fibula and tibia were coarsened to form a scaly bed using a bone chisel; an iliac bone block was grafted between them; and a screw was then used to fix them for synostosis. Alternatively, Ertl’s osteoplastic procedure [6] was also performed to obtain a bone bridge fusion (Figure 4) by making a flap of periosteum, to which chips of bone remained attached.Figure 4


Surgical revision for stump problems after traumatic above-ankle amputations of the lower extremity.

Liu K, Tang T, Wang A, Cui S - BMC Musculoskelet Disord (2015)

The synostosis of tibia and fibula was achieved using Ertl’s technique with the formation of a bone bridge.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4352282&req=5

Fig4: The synostosis of tibia and fibula was achieved using Ertl’s technique with the formation of a bone bridge.
Mentions: If there was a longer and prominent fibula in the residual lower leg, an osteoplastic procedure was performed, that has been well documented in previous reports [3-7]. After the fibular shortening, the opposite surfaces of the fibula and tibia were coarsened to form a scaly bed using a bone chisel; an iliac bone block was grafted between them; and a screw was then used to fix them for synostosis. Alternatively, Ertl’s osteoplastic procedure [6] was also performed to obtain a bone bridge fusion (Figure 4) by making a flap of periosteum, to which chips of bone remained attached.Figure 4

Bottom Line: A total of 80 stumps were treated surgically.The frequency of excess soft tissue in above-knee amputation cases was higher than that in below-knee amputation (p = 0.007).There was a significant difference in the ADL scores between admission and discharge (p = 0.000).

View Article: PubMed Central - PubMed

Affiliation: School of Rehabilitation Medicine, Capital Medical University, Beijing, China. keminlqliu@sina.com.

ABSTRACT

Background: Stump problems (SPs) secondary to traumatic lower limb amputation had a crucial influence on amputees' ability to return to living and work. The purpose of this study was to investigate the surgical management strategies of the SPs after above-ankle amputation of the lower limb secondary to trauma.

Method: A cohort of clinical cases, who were troubled by SPs after above-ankle amputation following trauma, had undergone revision surgery of the stump and was analyzed retrospectively. Various factors were noted like sex, unilateral or bilateral, amputation type, and causes of trauma. Different SPs like excess soft tissue (where a considerable amount of soft tissue interposed between the rigid elements which hindered the fitting of a prosthesis), scar, ulcers, neuromas, and bone spurs were taken as dependent variables. The relationship between factors and SPs was analyzed.

Results: A total of 80 stumps were treated surgically. The frequency of excess soft tissue in above-knee amputation cases was higher than that in below-knee amputation (p = 0.007). Bone spur occurred more frequently in the unilateral amputation than in bilateral ones (p = 0.018). There was a significant difference in the ADL scores between admission and discharge (p = 0.000).

Conclusion: Stump problems secondary to traumatic lower limb amputation had crucial influence on amputees' ability to return to living and work, appropriate evaluation and timely surgical revision showed excellent results.

Show MeSH
Related in: MedlinePlus