Effect of different partial foot amputation levels on gait

Abstract

目的部分足截肢手术是临床截肢手术中最常见的截肢类型,跖趾关节部位、跖骨部位和Lisfrane关节部位是PFA最典型的3种截肢平面,分析经这些平面的部分足截肢对步态的影响,将有助于相关辅具的设计和评价。方法采用Footscan平板式足底压力测试系统和Optotrak三维运动分析系统,以跨步长、步频、步速、足底各区域的峰值压力、冲量、接触时间、接触面积为特征参量,对这3种截肢平面患者进行了步态分析。结果分析结果表明,3种不同足部截肢平面中,残足越短,跨步长越小,双足承重时间差越明显;MTP的峰值压力主要在跖骨处和足跟处,TMA和Lisfrane的峰值压力集中在足中部和足跟处。结论推断在设计和评价不同足部截肢平面的相关辅具时,不同截肢平面辅具有相应差异。 Objective Partial Foot Amputation(PFA) is the most commonly amputation employed in clinic.Analysis of gait changes caused by three typical amputation levels of PFA(Metatarsophalangeal joints,transmetatarsal and Lisfrane joints) will contribute to design suitable aid devices,such as orthopedic shoes,partial foot prosthesis,and so on.Method Measure the walk speed,step length,step frequency,peak plantar pressure,impulse,contact time and contact area with Footscan plantar pressure measure system and OPTOTRAK motion analysis system, and then compare these parameters according to the three amputation levels.Result The gaits are obvious different among these three different levels of foot amputation: the shorter the residual foot,the shorter the step and the more obvious for biped loading time difference;peak force occurs mainly at the metatarsal and the heel area for the MTP,while for the TMA and Lisfrane amputation,it occurs at the midfoot and heel area. Conclusions It might important to take into account of amputation level when aid device is designed for PFA patient to improve the gait.