Transtibial Protez Soket Proksimal Kesim Çizgisinin Farklılığının Anlık Klinik Sonuçlar Üzerine Etkisi: Bir Olgu Sunumu

Year 2024, Volume: 2 Issue: 2, 34 - 45, 31.08.2024

Ayşe Yazgan

Abstract

Transtibial protez soketi proksimal sınırları tasarlanırken genel bir standart mevcuttur. Ancak vakum sistemli süspansiyon yöntemleriyle üretilen soketlerde proksimal kesim çizgileri değişkenlik gösterebilmektedir. Bu çalışmada transtibial protez soket proksimal kesim çizgi farklılığının ampute birey üzerinde anlık olarak memnuniyet, ağrı düzeyi ve fonksiyonellik üzerine etkisini araştırmak amaçlanmıştır. Çalışmaya 47 yaşında K3 aktivite düzeyinde bir unilateral transtibial erkek ampute dahil edildi. Ampute bireyin mevcut protezi Total Temaslı Soket (TTS) tipi pasif vakum süspansiyon sistemli bir protezdi. Ampute bireyin güdük ölçüsü Scaniverse 3D tarama uygulamasıyla alındı. Pozitif model Bilgisayar Destekli Tasarım (CAD yazılımı Meshmixer®️ (Autodesk, San Rafael, CA, USA) programında oluşturuldu ve hassas bölgeler üzerinde gerekli düzenlemeler yapıldı. Creality Ender-3 (Shenzhen, China) yazıcı kullanılarak Polilaktik Asit (PLA) filamenti kullanılarak ve soketin kesim çizgisini farklılaştırılarak oluşturulan Söderberg tip soket (STS) tasarlandı. Ampute bireyde fonksiyonel kapasite 6 Dakika Yürüme Testi (6DYT), Zamanlı Kalk Yürü Testi (ZKYT) ve Merdiven İnip Çıkma Testi (MİÇT) ile, soket konforu Soket Konfor Skoru (SKS) ve ağrı düzeyi Görsel Analog Skala (GAS) ile ölçüldü. GAS her iki soket tasarımı için de 0, SKS; TTS ile 7, STS ile 8 olarak ölçüldü. MİÇT; TTS ile 11,20 saniye, STS ile 10,50 saniye: ZKYT; TTS ile 9,55 saniye STS ile 8,62 saniye olarak kaydedildi. 6DYT; TTS ile 350 metre, STS ile 372 metre olarak ölçüldü. Ampute bireyin MİÇT ve ZKYT süresi azalırken, 6DYT mesafesi ve SKS puanı arttı. GAS skorunda herhangi bir değişim gözlenmedi. Çalışmamızda STS kullanımıyla fonksiyonel kapasite ve soket konforu artarken ağrı düzeyinde farklılık bulunmamıştır ancak daha kapsamlı sonuçlar için uzun süreli kullanıma dayalı çalışmalara ihtiyaç duyulmaktadır.

Keywords

Transtibial Amputeler, Transtibial soket, Kesim Çizgisi, Protez

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