应用胫腓骨骨桥技术的小腿截肢术时空参数步态分析

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摘要目的比较应用胫腓骨骨桥技术的小腿截肢术与传统小腿截肢术对时空参数步态分析的影响。方法 2005年11月至2016年1月，我院骨科收治小腿截肢患者32例，根据术中病情分为骨桥组和对照组。骨桥组12例，全部应用胫腓骨骨桥技术进行小腿截肢术，其中男11例，女1例；年龄27～60岁，平均(42.8±10.1)岁；毁损伤10例，外周血管病变1例，恶性肿瘤1例；小腿上段截肢8例，小腿中段截肢4例；左侧7例，右侧5例。对照组20例，全部采用传统截肢术，其中男16例，女4例；年龄30～65岁，平均(47.3±9.1)岁；毁损伤16例，外周血管病变3例，恶性肿瘤1例；小腿上段截肢12例，小腿中段截肢8例；左侧13例，右侧7例。术后1年进行时空参数步态分析，记录患者身高、体重、步速、步频、步长、步宽、摆动相、单足支撑相、双足支撑相、对称性、平均足底压强和最大足底压强。结果两组小腿截肢患者性别、年龄、截肢原因、截肢平面、侧别、体重和身高等比较，差异均无统计学意义(P＞0.05)，具有可比性。两组患者步长和步宽比较差异无统计学意义(F＝0.227，P＝0.962；F＝0.015，P＝1.000)，而骨桥组在步速、步频、摆动相、单足支撑相、双足支撑相、对称性、平均足底压强和最大足底压强等方面均优于对照组，差异有统计学意义(F＝4.722，P＜0.001；F＝1.007，P＝0.043；F＝2.087，P＝0.036；F＝2.157，P＝0.034；F＝5.382，P＝0.022；F＝3.121，P＝0.005；F＝2.224，P＝0.038)。结论胫腓骨骨桥技术应用于小腿截肢术中可获得良好的步态时空参数，行走功能和步态外观满意，是一种值得推广的小腿截肢方法。

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关键词 ：胫腓骨骨桥, 小腿截肢术, 步态分析, 时空参数

Abstract：Objective To compare the temporal-spatial gait analysis between transtibial amputation with tibiofibular bone bridging technique and traditional transtibial amputation.Methods There were 12 patients in bone-bridging group which underwent transtibial amputation with tibiofibular bone bridging technique，and 20 patients in control group which underwent traditional transtibial amputation.From November 2005 to January 2016.In bone-bridging group，the average age was(42.8±10.1)years，and there were 11 male cases and 1 female case.The reason of amputation were trauma in 10 cases，vascular disease in 1 case and malignant tumour in 1 case.There were 8 cases at proximal tibia，and 4 cases in the middle of tibia.There were 7 cases of left side and 5 cases of right.In control group，the average age was(47.3±9.1)and there were 16 cases of male and 6 cases of female.The amputation reason were trauma in 16 cases，vascular disease in 3 cases and malignant tumour in 1 case.There were 12 cases at proximal tibia，and 8 cases in the middle of tibia.There were 13 cases at left side and 7 cases at right.We recorded height，weight，velocity，cadence，stride length，step width，swing phage，single support time，double support time，symmetry，average pressure intensity，maximal pressure intensity.Results There were no significant difference between two groups with regard to sex，age，amputation reason，amputation level，side，weight and height(P＞0.05).Between two groups，there were no significant difference with ragard to stride length and step width(F＝0.227，P＝0.962；F＝0.015，P＝1.000)，but there were significant difference with regard to velocity，cadence，swing phage，single support time，double support time，symmetry，average pressure intensity，maximal pressure intensity(F＝4.722，P＜0.001；F＝1.007，P＝0.043；F＝2.087，P＝0.036；F＝2.157，P＝0.034；F＝5.382，P＝0.022；F＝3.121，P＝0.005；F＝2.224，P＝0.038).Conclusion Transtibial amputation with tibiofibular bone bridging technique can obtain good temporal-spatial gait analysis data，walking function and gait feature.It is a worth recommending amputation pattern.

Key words： tibiofibular bone bridgeing transtibial amputation gait analysis temporal-spatial parameters

作者简介: 杨照田(1969— )，男，副主任医师，解放军第180医院骨二科，362000。

引用本文:

杨照田，吕辉照，赵枫，曹杰，张冬福. 应用胫腓骨骨桥技术的小腿截肢术时空参数步态分析[J]. 实用骨科杂志, 2018, 24(5): 414-417.
Yang Zhaotian，Lü Huizhao，Zhao Feng，et al. Temporal-Spatial Gait Analysis for Transtibial Amputation with Tibiofibular Bone Bridging Technique. sygkzz, 2018, 24(5): 414-417.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2018/V24/I5/414

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