Self-reported health outcomes and medical complications at 6- and 8-year follow-up after direct skeletal fixation in individuals with bilateral transfemoral amputations
研究了8名英国军人双侧大腿截肢者接受直接骨骼固定术后6年和8年的身体与心理健康变化，发现身体功能显著改善，但存在感染等并发症。
Direct skeletal fixation (DSF) involves attaching the intramedullary portion of a prosthesis directly to the skeletal residuum, providing an alternative for amputees unable to mobilise with socket-based prostheses. This study investigates the effects of DSF on physical and mental health at 6- and 8-year follow-up for military bilateral transfemoral amputees in the UK. Eight male bilateral transfemoral military amputees who underwent implantation with the Osseointegration Group of Australia-Osseointegration Prosthetic Limb prosthesis consented to participate in the study. All patients are routinely reviewed annually in a dedicated clinic, and this paper reports the 6- and 8-year follow-ups. Patient-reported outcomes were assessed using the Short Form Health Survey (SF-36). Complications data were recorded at the 8-year follow-up. The SF-36 physical component score significantly increased from preoperative levels at 6 years (median: 29 vs. 47; P = 0.003) and 8 years (median: 29 vs. 45; P = 0.024). The SF-36 mental health component score improved significantly at 6 years from preop (median: 39 vs. 57; P = 0.011). Among 16 femoral residuums, there was one explantation because of infection at 8.5 years postimplantation, and two cases were managed with long-term suppressive antibiotics. A total of 17 additional procedures were performed on nine residuums: 11 for soft tissue revision, five for infection, and one for fracture repair. This research adds to the growing evidence base that DSF has the potential to enhance the health and well-being of amputee veterans and potentially the broader amputee population. Medical complications remain an important consideration.