PDF(Pubmed)
Abstract：
The aim of the present case report was to provide a longitudinal functional assessment of a patient with transfemoral amputation from the preoperative status with socket-type prosthesis to one year after the osseointegration surgery. A 44 years-old male patient was scheduled for osseointegration surgery 17 years after transfemoral amputation. Gait analysis was performed through 15 wearable inertial sensors (MTw Awinda, Xsens) before surgery (patient wearing his standard socket-type prosthesis) and at 3-, 6-, and 12-month follow-ups after osseointegration. ANOVA in Statistical Parametric Mapping was used to assess the changes in amputee and sound limb hip and pelvis kinematics. The gait symmetry index progressively improved from the pre-op with socket-type (1.14) to the last follow-up (1.04). Step width after osseointegration surgery was half of the pre-op. Hip flexion-extension range significantly improved at follow-ups while frontal and transverse plane rotations decreased (p < 0.001). Pelvis anteversion, obliquity, and rotation also decreased over time (p < 0.001). Spatiotemporal and gait kinematics improved after osseointegration surgery. One year after surgery, symmetry indices were close to non-pathological gait and gait compensation was sensibly decreased. From a functional point of view, osseointegration surgery could be a valid solution in patients with transfemoral amputation facing issues with traditional socket-type prosthesis.
摘要：
本病例报告的目的是提供经股截肢患者的纵向功能评估，从术前接受接受腔式假体到骨整合手术后一年。一名44岁的男性患者计划在经股截肢17年后进行骨整合手术。通过15个可穿戴惯性传感器(MTwAwinda，Xsens）手术前（患者佩戴其标准接受腔式假体）和3-，6-，和骨整合后12个月的随访。统计参数映射中的方差分析用于评估截肢者和健全的肢体髋关节和骨盆运动学的变化。步态对称性指数从带有套节类型的术前（1.14）到最后一次随访（1.04）逐渐提高。骨整合手术后的步宽是术前的一半。髋关节屈伸范围在随访时显着改善，而额面和横向平面旋转减少（p<0.001）。骨盆前倾,倾斜度，和旋转也随着时间的推移而减少（p<0.001）。骨整合手术后时空和步态运动学得到改善。手术一年后,对称性指数接近非病理性步态，步态补偿明显下降。从功能的角度来看，骨整合手术可能是经股截肢患者面临传统接受腔式假体问题的有效解决方案。
