1. Ljubomir Panajotović, Albania
Functional, stable knee joint and a durable below-knee amputation stump, long enough for prosthesis ambulation are a boon to the patient who suffers lower limb loss in the war. However, in some patients the injury is so close to the knee joint with insufficient local soft tissue for coverage. This circumstance has traditionally been treated by a higher amputation or by local or distant flap transfer.
Twelve severe war wounded patients with acute and chronic traumatic below-knee amputation underwent free tissue transfer in our clinic to save or to augment their stumps.At the time of operation,tibia was 8 cm (6-9) long from the tibia tubercle to the top of the stump. Except in the case of urgent free flap the duration from amputation to free flap reconstruction was 7 months to 1, 5 year. In all patients we made Scapular skin free flap. In all of them we started with preparation of the stump for prosthesis 15th days after operation.
Average time between operation and use of prosthesis was two months. The range of motion in the knee joint was 90-100 degree. Sensibility tests showed that touch sense was first detected 6 months and established 36 months after operation. Pain sensitivity was first detected 12 months after operation. The pattern of sensibility may indicate neurotisation from the peripheral skin. However in patients who have undergone free tissue transfer to below-knee stump, stump changes may be located anywhere on the stump. The problem of ulcerations was resolved by altering stump socks.
Ključne reči :
Tematska oblast:
Ortotika, protetika i robotika u FRM
Uvodni rad:
Da
Datum:
20.07.2012.
Br. otvaranja:
395
