2017, Number 5
<< Back Next >>
Acta Ortop Mex 2017; 31 (5)
Bilateral amputation in diabetic patient with blindness, the use of inadequate prosthesis. Case report
González-García B, García-Isidoro S, Contreras-Alcántara J, Martínez-Gil JA, Díaz y Orea MA, Castellanos-Sánchez VO
Language: Spanish
References: 32
Page: 239-247
PDF size: 330.80 Kb.
ABSTRACT
The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal» or «rustic» systems that hamper their adaptation process. We present herein the case of a 47 year-old female patient, housewife, with bilateral paresthesias and phantom limb sensation associated with amputation neuromas resulting from type II diabetes mellitus that had affected the patient for eight years. This patient of a low socioeconomic stratum underwent a post-amputation assessment and was diagnosed as being heavily dependent when performing activities of daily living and required assisted wheelchair for ambulation. This is a frequent variant resulting from bilateral loss of lower limbs together with complete loss of vision. We describe the rehabilitation therapy during the pre- and post-prosthetic stages, together with the results of the assessments to show the effectiveness of the treatment process, without forgetting the participation of the caregiver as a fundamental co-therapeutic element in this process.
REFERENCES
Hafner BJ, Sanders JE: Considerations for development of sensing and monitoring tools to facilitate treatment and care of persons with lower-limb loss: a review. J Rehabil Res Dev. 2014; 51(1): 1-14.
Boulton AJ, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al: Comprehensive foot examination and risk assessment. Diabetes Care. 2008; 31(8): 1679-85.
Icks A, Haastert B, Trautner C, Giani G, Glaeske G, Hoffmann F: Incidence of lower-limb amputations in the diabetic compared to the non-diabetic population. Findings from nationwide insurance data, Germany, 2005–2007. Exp Clin Endocrinol Diabetes. 2009; 117(9): 500-4. doi: 10.1055/s-0029-1225333.
Vamos EP, Bottle A, Majeed A, Millett C: Trends in lower extremity amputations in people with and without diabetes in England, 1996-2005. Diabetes Res Clin Pract. 2010; 87(2): 275-82. doi:10.1016/j.diabres.2009.11.016.
Cisneros-González N, Ascencio-Montiel IJ, Libreros-Bango VN, Rodríguez-Vázquez H, Campos-Hernández Á, Dávila-Torres J, et al: Lower extremity amputation rates in diabetic patients. Rev Med Inst Mex Seguro Soc. 2016; 54(4): 472-9.
Seuring T, Archangelidi O, Suhrcke M: The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics. 2015; 33(8): 811-31. doi: 10.1007/s40273-015-0268-9.
Montori VM, Rodriguez-Gutierrez R: The triumph of innovation and the hard work of caring for patients with diabetes. Ann Intern Med. 2016 Jan 19; 164(2):127-8.
Zhou M, Wang W, Huang W, Zhang X: Diabetes mellitus as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. PLoS One. 2014; 9(8): 19 e102972. doi: 10.1371/journal.pone.0102972. eCollection 2014
Mills T, Law SK, Walt J, Buchholz P, Hansen J: Quality of life in glaucoma and three other chronic diseases: a systematic literature review. Drugs Aging. 2009; 26(11): 933-50.
Villena JE. Diabetes mellitus in Peru. Ann Glob Health. 2015; 81(6): 765-75. doi: 10.1016/j.aogh.2015.12.018.
World Confederation for Physical Therapy. Policy Statement: description of physical therapy, World Confederation for Physical Therapy. 2011. Available at: www.wcpt.org/policy/ps-descriptionPT. Accessed June 22, 2016.
Hawkins AT, Pallangyo AJ, Herman AM, Schaumeier MJ, Smith AD, Hevelone ND, et al: The effect of social integration on outcomes after major lower extremity amputation. J Vasc Surg. 2016; 63(1): 154-62.
Navarro-Flores E, Gijón-Noguerón G, Cervera-Marín JA, Labajos-Manzanares MT. Assessment of foot self-care in patients with diabetes: retrospective assessment (2008-2014). Foot Ankle Spec. 2015; 8(5): 406-12.
Matthews D, Sukeik M, Haddad F. Return to sport following amputation. J Sports Med Phys Fitness. 2014; 54(4): 481-6.
Serra Gabriel MR, Viver Manresa E. El paciente amputado: labor de equipo. Edit Elsevier España. 2001.
Crowell MS, Deyle GD, Owens J, Gill NW: Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series. J Man Manip Ther. 2016; 24(1): 34-44.
Kristensen MT, Holm G, Krasheninnikoff M, Jensen PS, Gebuhr P: An enhanced treatment program with markedly reduced mortality after a transtibial or higher non-traumatic lower extremity amputation. Acta Orthop. 2016; 87(3): 306-11.
Hansen C, Godfrey B, Wixom J, McFadden M: Incidence, severity, and impact of hyperhidrosis in people with lower-limb amputation. J Rehabil Res Dev. 2015; 52(1): 31-40.
Maki S, Koda M, Furuya T, Takahashi K, Yamazaki M: Severe pain as a possible cause of dropped head syndrome that was attenuated after amputation of an ischemic lower limb. BMC Res Notes. 2016; 9: 137. doi: 10.1186/s13104-016-1952-3.
Teall T, Barrera M, Barr R, Silva M, Greenberg M: Psychological resilience in adolescent and young adult survivors of lower extremity bone tumors. Pediatr Blood Cancer. 2013; 60(7): 1223-30.
Marks LJ, Michael JW. Science, medicine, and the future: artificial limbs. BMJ. 2001; 323(7315): 732-5.
Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S, Arifin N, Wan Abas WA. Evaluation of new suspension system for limb prosthetics. Biomed Eng Online. 2014; 13: 1. doi: 10.1186/1475-925X-13-1.
Campbell AI, Sexton S, Schaschke CJ, Kinsman H, McLaughlin B, Boyle M. Prosthetic limb sockets from plant-based composite materials. Prosthet Orthot Int. 2012; 36(2): 181-9. doi: 10.1177/0309364611434568
Czerniecki JM, Morgenroth DC. Metabolic energy expenditure of ambulation in lower extremity amputees: what have we learned and what are the next steps? Disabil Rehabil. 2015; 1-9.
Esposito ER, Rodriguez KM, Ràbago CA, Wilken JM: Does unilateral transtibial amputation lead to greater metabolic demand during walking? J Rehabil Res Dev. 2014; 51(8): 1287-96.
Bennett AW Jr. A primer on limb prosthetics. Springfield: Charles C. Thomas Publishing. 1998.
Michael JW, Bowker JH. Atlas of amputations and limb deficiencies: surgical, prosthetic, and rehabilitation principles. In: Smith DG, Michael JW, Bowker JH (eds). American Academy of Orthopaedic Surgeons; 3rd edition, 2004.
Carey SL, Lura DJ, Highsmith MJ; CP; FAAOP: Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review. J Rehabil Res Dev. 2015; 52(3): 247-62.
Tucker MR, Olivier J, Pagel A, Bleuler H, Bouri M, Lambercy O, et al. Control strategies for active lower extremity prosthetics and orthotics: a review. J Neuroeng Rehabil. 2015; 12: 1. doi: 10.1186/1743-0003-12-1.
Gottschalk F. Transfemoral amputation biomechanics and surgery. Clin Orthop Relat Res. 1999; 361: 15-22.
Wetterhahn K, Hanson C, Levy CE. Effect of participation in physical activity on body image of amputees. Am J Phys Med Rehabil. 2002; 81(3): 194-201.
Meier RH 3rd, Heckman JT. Principles of contemporary amputation rehabilitation in the United States, 2013. Phys Med Rehabil Clin N Am. 2014; 25(1): 29-33.