P-3-03-01
THE PREFECTURAL REHABILITATION CENTER'S ROLE AS A LIMB FITTING CENTER
Tatsuro Nagao (Toyama Prefectural Koshi Rehabilitation Hospital, Toyama, Japan)
Since the opening in 1984, Toyama Prefectural Koshi Rehabilitation Hospital (KRH) has been taking important role as a limb fitting center for the amputee in Toyama prefecture. In addition, It played as a R&D facility of rehabilitation engineering and an under/post graduate teaching facility for several medical professions. KRH treated 120 amputees since 1984. While only 10 patients were initially amputated here, 100 patients have been referred for post-amputation rehabilitation program, which were not indicated for 10 patients for miscellaneous reasons.
The chronic amputees within the prefecture are physically checked once in several years and the prostheses are renewed and checked in KRH in close cooperation with Toyama Rehabilitation Consultation Center for Physically Disabled Persons (TRCC). The amputees are admitted to KRH if necessary for further assessment, training, medical or surgical treatment. We also make travelling consultations more than 10 times in respective areas with the members of TRCC.
Statistical details will be disclosed. Several medical and administrative problems confronting our system will be discussed.
P-3-03-02
IS IT POSSIBLE TO LOWER THE AMPUTATION LEVEL AND TO IMPROVE OUTCOMES OF REHABILITATION IN PATIENTS WITH CRITICAL ISCHEMIA
Zoloyev G.K., Ivatsin N.P., Litvinovsky S.V., Korolev S.G. (Orthopaedic Centre for Rehabilitation of Disabled People, Novokuznetsk, Russia)
Outcomes of treatment and movement rehabilitation of 348 patients with critical lower extremity ischemia were analysed. We revealed that number of above-the-knee amputation was four times higher than below-the-knee amputation that may be explained by great risk of postoperative complication mostly caused by ischemia of the lower- extremity long stump.
The effective method of prevention of ischemia of the long stump was surgical repair of circulation via deep artery of the thigh and obligatory elimination of the superficial femoral artery from the systemic circulation. In 67 % it allowed to shape functional shin stump and in 33 % to perform the Gritty's operation. Outcomes of movement rehabilitation was much better in patients with below-the-knee amputation if to compare with the group of patients who underwent above-the-knee amputation.
