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RISS 인기검색어
- 검색키워드
- 저자 : Charles G Crone (검색결과 2 건)
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Through Knee Amputation: Technique Modifications and Surgical Outcomes
Albino, Frank P.,Seidel, Rachel,Brown, Benjamin J.,Crone, Charles G.,Attinger, Christopher E. Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.5
Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.
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Through Knee Amputation: Technique Modifications and Surgical Outcomes
Frank P Albino,Rachel Seidel,Benjamin J Brown,Charles G Crone,Christopher E Attinger 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5
Background: Knee disarticulations (KD) are most commonly employed following trauma ortumor resection but represent less than 2% of all lower extremity amputations performed inthe United States annually. KDs provide enhanced proprioception, a long lever arm, preservationof adductor muscle insertion, decreased metabolic cost of ambulation, and an endweight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelminginfection is less clear. The purpose of this study is to describe technique modifications andreport surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods: A retrospective study of medical records for all patients who underwent a throughkneeamputation performed by the senior author (C.E.A.) between 2004 and 2012 wascompleted. Medical records were reviewed to collect demographic, operative, and postoperativeinformation for each of the patients identified. Results: Between 2004 and 2012, 46 through-knee amputations for 41 patients wereperformed. The mean patient age was 68 and indications for surgery included infection (56%),arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficialcellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case ofsurgical debridement (4%) and four trans-femoral amputations (9%). 9 (22%) patients wenton to ambulate. Postoperative ambulation was greatest in the traumatic cohort and forpatients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infectionreduced the likelihood of postoperative ambulation, P<0.01. Conclusions: Knee disarticulations are a safe and effective alternative to other lower extremityamputations when clinically feasible. For patient unlikely to ambulate, a through-kneeamputation maximizes ease of transfers, promotes mobility by providing a counterbalance,and eliminates the potential for knee flexion contracture with subsequent skin breakdown.
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