Surgical technique of a bone-anchored prosthesis for transhumeral amputees.

IF 1 4区医学 Q3 ORTHOPEDICS

Operative Orthopadie Und Traumatologie Pub Date : 2025-04-01 Epub Date: 2025-03-14 DOI:10.1007/s00064-025-00894-w

Jan Paul Frölke, Horst Aschoff, Henk Van de Meent, Thomas Mittlmeier

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引用次数: 0

Abstract

Objective: Fixating an arm prosthesis with a transcutaneous bone anchor provides a more comfortable and stable attachment than conventional socket-attached prosthetics. The objective is that bone anchoring will improve prosthetic usage, reduce prosthesis rejection, and aid to functions in daily life activities.

Indications: Subjects with transhumeral amputation or elbow disarticulation and insufficient functional effect of conventional socket-attached arm prostheses.

Contraindications: Patients with local or systemic inflammatory processes, bone metabolism disorder, active use of chemotherapeutic or immunosuppressive medications and medically unexplained pain conditions in the respective residual arm.

Surgical technique: A cylindrical BADAL next (OTN Implants Germany, Rostock, Germany) humerus implant is transcutaneously inserted using a retrograde press-fit approach. The distal taper of the implant is connected to an adapter that serves as an abutment for the fixation of the postoperative load-set and arm prosthesis.

Postoperative management: Postoperative pain medication according to standard guidelines for shoulder surgery. Stoma care instructions before discharge from the hospital. Progressive loading at 6 weeks postoperatively using load plates of 100 g using in a compatible load set. Installation of an external arm prosthesis as soon as the weight of the arm prosthesis is reached.

Results: In 4 individuals with median follow-up of 11 months, implant survival was 100%, prosthetic use improved from 0 h to an average 14 h per week, and no arm prosthesis rejection occurred. On a functional level, the 4 individuals improved from 0 to 5 on the patient-reported outcome measure (PROM) 33ADL PWP. This PROM measures 33 daily activities that can or can not be carried out with the prosthesis. No adverse events were reported.

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经肱骨截肢者骨锚定假体的外科技术。

目的：采用经皮骨锚固定手臂假体比传统的套接式假体更舒适、稳定。目的是骨锚定将改善假体的使用，减少假体排斥反应，并有助于日常生活活动的功能。适应症：经肱骨截肢或肘关节脱臼，常规套接臂假体功能效果不足的患者。禁忌症：局部或全身性炎症过程，骨代谢紊乱，积极使用化疗或免疫抑制药物以及各自残肢中医学上无法解释的疼痛状况的患者。手术技术：采用逆行压合入路经皮置入圆柱形BADAL next （OTN implant Germany, Rostock, Germany）肱骨假体。种植体的远端锥度连接到一个适配器，该适配器用作基台，用于固定术后负载集和手臂假体。术后处理：术后按照肩部手术标准指南进行止痛药治疗。出院前的护理说明。术后6周渐进式加载，使用100 g的负载板，在兼容负载组中使用。一旦达到手臂假体的重量，立即安装外部手臂假体。结果：4例患者中位随访11个月，假体存活率为100%，假体使用从0 h改善到平均每周14 h，无手臂假体排斥反应发生。在功能水平上，4名患者在患者报告的结果测量（PROM） 33ADL PWP上从0提高到5。这个PROM测量了33种日常活动，这些活动可以或不可以用假体进行。无不良事件报告。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.