PDF(Pubmed)
Abstract：
Conjoined twins are identical twins joined in utero and are a rare phenomenon. This report discusses a case of female thoraco-omphalo-ischiopagus tripus conjoined twins. The twins were separated at age two, and once medically stable, spent one month in inpatient rehabilitation to improve their sitting balance and gross motor skills. This was followed by outpatient physical therapy. The twins initially had customized ZipZac seats, which they were able to wheel independently. After six months of therapy, the girls began walking with posterior walkers and prostheses. The hemipelvectomy prosthesis included a customized thoracolumbosacral orthosis component and was directly attached to a non-articulated pylon. A manual-locking hip joint was added to accommodate sitting. An articulated ankle-foot orthosis was used for the intact leg. Care of formerly conjoined twins requires comprehensive care from a multidisciplinary team involving, but not limited to, a physiatrist, orthopaedic surgeon, physical therapist, and orthotist/prosthetist. Complex congenital limb deficiencies are often a major undertaking for the rehabilitation team as continuous treatment and management are needed throughout the patient\'s lifetime due to growth, development, and evolving physical demands. Anatomic variations must be examined on a case-by-case basis but often include limb deficiencies, orthopedic abnormalities, and organ comorbidities.
摘要：
连体双胞胎是在子宫内连接的同卵双胞胎，是一种罕见的现象。本报告讨论了1例女性胸-omphalo-坐骨三连体双胞胎。这对双胞胎两岁时分居，一旦医学稳定，花了一个月的住院康复，以改善他们的坐姿平衡和粗大运动技能。随后是门诊物理治疗。这对双胞胎最初定制了ZipZac座椅，他们能够独立驾驶。经过六个月的治疗,女孩们开始用后路助行器和假肢走路。半骨盆切除术假体包括定制的胸腰骶骨矫形器组件，并直接连接到非铰接支架上。增加了手动锁定髋关节以适应坐着。铰接的踝足矫形器用于完整的腿。以前连体双胞胎的护理需要多学科团队的全面护理，但不限于,一个理疗师,整形外科医生,物理治疗师,和矫形师/假肢。复杂的先天性肢体缺陷通常是康复团队的主要任务，因为由于成长，需要在患者的整个生命周期中进行持续的治疗和管理，发展,不断发展的物质需求。必须根据具体情况检查解剖变异，但通常包括肢体缺陷，骨科异常,和器官合并症。
