Article

While discussion about the benefits and complications of partial foot amputation
(PFA) is not new, much of it has hinged on anecdotal evidence and led to the
popular view that the risk of complications and secondary amputation is
reasonable when weighed against the perceived benefits associated with
maintaining the ankle joint and residual foot length, including more normal
walking, reduced energy expenditure, and improved quality of life. The research
evidence makes it difficult not to question whether these benefits are valid and
worth striving to achieve. When you consider that persons who undergo PFA are
typically in the later years of their life and have limited mobility, it raises
the question of whether we place too much emphasis on achieving the purported
functional benefits of PFA and too little emphasis on achieving primary wound
healing and mitigating the high rates of complications and subsequent amputation.
If further research supports what we see emerging in the evidence, there will be
a case to be made for selecting the level of PFA based primarily on the potential
for wound healing, rather than trying to strike a balance with the perceived
functional benefits. This may mean that transtibial amputation is preferable in
many cases, given the lower rates of complications and secondary amputation, very
similar function in terms of walking and energy expenditure, and similar lived
experience of limb loss when compared with persons with PFA. Further research is
needed to better understand the complications and benefits of PFA to make this a
more viable, first-and-final amputation procedure.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS