Replantation and Revascularization of Lower Extremity

下肢完全或不完全截肢並不常見但對重建醫師來說卻是一項挑戰。最近十年，我們共治療三例完全截肢，十例不完全截肢病例。有七例受傷部位在下肢，三例在足踝，兩例在足部，一例位於腳趾。三例完全截肢重接成功，其中包括一例雙重部位截斷，有九例不完全截肢血流重建成功。一位病患在受傷後一個半月因為嚴重感染而接受膝上截肢。兩位病患在半年後因疼痛而接受膝下截肢。其餘病例都能達到骨癒合及感覺恢復。九例病患最終得到完全負重步行，一例病患須輔助步行。大部份病例對結果感到滿意。本院經驗顯示，在有條件的選擇下，下肢截斷重接是值得嘗試，且相較於輔具，更能提供較好的功能及外觀。

關鍵字

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並列摘要

Replantation of a completely or incompletely amputated lower extremity is less common yet challenging for reconstructive surgeons. In the recent ten years, 3cases of complete amputation and10 cases of incomplete amputation were treated at Kaohsiung Chang Gung Memorial Hospital: 7 cases at the level of lower leg 3 at ankle level, one at heel level, 2 at midfoot and one at toe level. Of these, 3 replanted cases successfully survived which included one two-level amputation case, and9 of 10revascularized cases were successful with surviving subjects. One patient received an above-knee amputation due to severe infection one and a half months after the first operation. Two patients underwent a secondary below-knee amputation half a year later for the reason of intractable pain. Apart from these, all other successful cases regained protective sensibility and bony union. Nine patients achieved full weight-bearing ambulation without heel ulceration while one patient was able to ambulate with crutch assistance. Most of these patients are satisfied with the results. Our experiences have shown that lower extremity replantation or revascularization is worth considering in selected cases, as those selected ones may prone toward better functional outcome, as well as superior aesthetic appearance than prosthetic alternatives.

並列關鍵字

lower extremity ； replantation ； revascularization Introduction

國際替代計量

Replantation and Revascularization of Lower Extremity

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