[A new method for prosthetisation of vascular patients with lower limb amputation: initial experiences with osseointegration technique].
OBJECTIVE
Prostheses use for lower limb amputees is difficult, while the socket is hard, the prosthesis is heavy. Drawbacks of conventional prosthesis are mainly associated with the socket, therefore osseointegration technique is a promising solution, since it doesn't require a socket. Our aim was to introduce this technique in Hungary and extend indication for vascular patients.


METHODS
The method includes two operative and one rehabilitation phases: during first operation a titanium screw is fixed into the femoral bone marrow cavity, this connects to an abutment, which also penetrates the skin, making a direct connection between the femur and the prosthesis during the second intervention. During rehabilitation the patient makes loading exercises and learns to walk with new prosthesis.


RESULTS
This method was launched in Hungary in 2005. Two female amputees were operated on initially, their second surgery was performed in 2006 (when titanium screw was applied in the male patients, as well). Incorporation of titanium screw was exquisite, and rehabilitation was successful. One of our male patients died eight months after his first operation due to myocardial infarction.


CONCLUSIONS
Based on our experiences, the osseointegration technique facilitates rehabilitation of vascular patients for prostheses use. Adequate follow-up and stable vascular diseases are not contraindications, although further clinical trials are needed to determine its indication.
Ferencz
Sándor
S
Pécsi Tudományegyetem Altalános Orvostudományi Kar, Sebészeti Oktató és Kutató Intézet, 7624 Pécs, Alkotmány u. 20. sandor.ferencz@gmail.com
Mangold
Viktória
V
Dérczy
Katalin
K
Takács
Ildikó
I
Balatonyi
Borbála
B
Horváth
Szabolcs
S
Jávor
Szaniszló
S
Brånemark
Rickard
R
Horváth
Ors Péter
OP
Roth
Erzsébet
E
Wéber
György
G
D000671:Amputation, Surgical; D001186:Artificial Limbs; D001863:Bone Screws; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005269:Femur; D006801:Humans; D006814:Hungary; D008297:Male; D016348:Osseointegration; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D012086:Reoperation; D013848:Thigh / Q000601:surgery*; D014025:Titanium; D016474:Weight-Bearing
D014025:Titanium