截肢者患有糖尿病和血管疾病的下肢骨质整合
Jason S Hoellwarth1, LaYow C Yu1, Tyler D DeSena1
1Limb Lengthening and Complex Reconstruction Service, Osseointegration Limb Replacement Center, Hospital for Special Surgery, New York, NY.
概括
骨整合在患有糖尿病 (DM) 和外周血管疾病 (PVD) 的截肢者中显示出有希望的安全性和有效性. 患者在结局和运动能力方面经历了显著的改善,并有可管理的并发症.
科学领域:
- 整形外科手术 整形外科手术
- 假肢和整形手术
- 康复医学 康复医学 康复医学
背景情况:
- 糖尿病 (DM) 和外周血管疾病 (PVD) 是截肢者常见的并发症.
- 这些情况可能会使假肢安装和康复复复杂化.
- 骨整合为改善假肢整合提供了一个潜在的替代方案.
研究的目的:
- 评估DM和/或PVD截肢者骨质整合的结果.
- 在这个患者群体中评估骨整合的安全性和有效性.
- 分析患者报告的结果和骨整合后的运动性能.
主要方法:
- 一个案例系列设计在一个城市三级推学术医疗中心被采用.
- 五名患者 (1名患有DM,3名患有PVD,1名患有两种疾病,4名穿骨,1名穿骨) 接受了按压整合骨质整合的修复截肢手术.
- 随访持续时间为4.1±0.3年,主要结局包括不良事件和二次结局包括PROM和流动性.
主要成果:
- 没有发生植入物松,骨折,全身并发症或死亡.
- 一名患者需要为骨髓炎进行脱bridement;两名患者接受了皮肤改造.
- 所有患者在患者报告的结果指标 (PROM) 和流动性 (至少一个K级增加) 均显著改善.
结论:
- 骨质整合是一种潜在的安全和有效的选择,用于选择患有DM和/或PVD的截肢者.
- 虽然可能会出现感染和皮肤冗余等并发症,但它们似乎是可以控制的.
- 骨整合可以在这个具有挑战性的患者群体中优化康复和假肢使用.
更多相关视频
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
484
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
484
01:26Peripheral Artery Disease IV: Nursing Management
506
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
506
01:30Peripheral Artery Disease I: Introduction
508
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
508
01:27Peripheral Artery Disease III: Interprofessional Care
457
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
457
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
546
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
546