足部截肢的假肢处理方式-课件.pptxVIP

Prosthetic Treatment for Partial Foot Amputation足部截肢的假肢处理方式 Christian Schlierf Prosthetist/Orthotist Guangzhou, China November 2011 Foot bone structures（足部骨骼结构） The 27 bones of the foot skeleton（足部27块骨骼） Forefoot（前足） Rear foot（后足） Digiti pedis (toes)脚趾部 Metatarsus (middle foot)中足 Tarsus (foot root)足跟 Levels of Foot Amputations（足部截肢平面） If amputation in the area of toes is needed, no middle or basic parts of bones should remain because they tend to deviate to wrong positions. （如果必须足趾截肢的话，中部骨骼或骨骼的根部没有必要留下，因为它们将会偏离到错误位置） The disarticulation is optimal in this case as it ensures unproblematic prosthetic treatment. （假如能确保假肢安装没问题的话，跖趾离断是最佳选择） An exception is the big toe. If only the hallux is amputated, only a stiff sole and an appropriate roll-over edge would be an adequate prosthetic treatment. The shoe should have a flat sole in order to avoid too much strain on the stump. Where toes II-V are amputated, an insole with some compensation of the shape would be appropriate. （大脚趾是个例外。如果大拇趾被截肢，具有滚动边的硬鞋垫就是合理的假肢处理方式。应该穿平底鞋，避免残趾处应力集中。第二至第五足趾截肢，残缺部补好形状的的鞋垫就可以。） Disarticulation of Toes（跖趾关节离断） International name: Trans-metatarsal peripheral amp. （国际通用名:经跖骨远端截肢） Clinical sign: Amputation according to Sharp（临床名：Sharp截肢) Here the amputation line goes through the heads of the metatarsus bones, therefore through the spongious bone areas. Amputations at the diaphysis level are very unfavorable because the bones thin down and become very pointed, thus making the prosthetic treatment very complicated. (截肢线经过跖骨头部，因此经过跖骨髁部。经跖骨干截肢不好，因为此处骨变小而且很尖，安装假肢将很复杂。） The ends of the bones cut by amputation must be well curved on the plantar side. The scar should be positioned on the cranial side of the foot so that the skin of the foot sole can be pulled over the ends of the cut bones. （被截肢骨末端的足底面应该圆滑修整，伤疤应该安置在足背面，因此，足底皮肤可以被拉上来覆盖截骨末端。） Transmetatarsal Amputation: Long Stump（经跖骨截肢:长残肢） Levels of Foot Amputations （足部截肢平面） International sign: Trans-metatarsal proximal amp. （国际通用名:经跖骨远端截肢） Clinical sign