Abdominal Shotgun Wound With Pellet Embolization Leading to Bilateral Lower Limb Amputation: Case Report and Review of the Literature of Missile Emboli Over the Past 10 Years

The objectives of this study were to evaluate the clinical features and outcomes of 43 bilateral lower limb amputees. The clinical features obtained included the causes of amputation, level of amputation, concurrent medical problems, and stump condition. Outcome measures were obtained using the activities of daily living (ADL) index, the Frenchay Activities Index (FAI), and mobility grading with prostheses or wheelchair. Of 33 amputees who were prosthetic ambulators, 22 (67%), mainly bilateral trans-tibial (TT) amputees, were community ambulators, and participated in activities which included stair-walking, and six of 11 household ambulators were combination trans-femoral (TF) and TT amputees. Of 10 amputees who were wheelchair ambulators, only one was able to perform wheelchair transfers independently and five were independent wheelchair ambulators. Using the ADL index and FAI, there was no significant difference in scores according to the level of amputation ( p > 0.05), but the scores of community prosthetic ambulators were significantly higher than those of wheelchair ambulators ( p < 0.05). Age was found to be negatively correlated with ADL index and FAI scores ( r = −0.518 vs. r = −0.550) ( p < 0.01). This study concludes that overall independence in ADL after bilateral lower limb amputation improved with young age and prosthetic mobility.

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Acute Parotitis after Lower Limb Amputation: A Case Report of a Rare Complication

Case Reports in Otolaryngology ◽

10.1155/2018/3714214 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Konstantinos Ioannis Avgerinos ◽

Nikolaos Degermetzoglou ◽

Sofia Theofanidou ◽

Georgia Kritikou ◽

Ioannis Bountouris

Keyword(s):

Risk Factors ◽

Case Report ◽

General Anesthesia ◽

Lower Limb ◽

Rare Complication ◽

Head Tilt ◽

Lower Limb Amputation ◽

Limb Amputation ◽

The Right ◽

Type Of Surgery

Background. Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report. An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee. On the 5th postoperative day, he was diagnosed with right parotitis probably because of dehydration, general anesthesia, and immunocompromisation. A CT scan confirmed the diagnosis. He received treatment with antibiotics and fluids. His condition gradually improved, and he was finally discharged on 15th postoperative day. Conclusions. Postoperative parotitis can possibly occur after any type of surgery including vascular. Clinicians should be aware of this complication although it is rare. Several risk factors such as dehydration, general anesthesia, drugs, immunocompromisation, head tilt during surgery, and stones in Stensen’s duct may predispose to postoperative parotitis. Treatment consists of antibiotics and hydration.

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Impact of pain in vertebral column on activities of daily living in the Iranian amputees with bilateral lower limb amputation

Disability and Rehabilitation ◽

10.3109/09638288.2011.623756 ◽

2011 ◽

Vol 34 (10) ◽

pp. 869-872 ◽

Cited By ~ 7

Author(s):

Alireza Ashraf ◽

Hadi Shojaee ◽

Batool Mousavi ◽

Mehdi Masoumi ◽

Noushin Rezaei ◽

...

Keyword(s):

Activities Of Daily Living ◽

Lower Limb ◽

Daily Living ◽

Vertebral Column ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Bilateral Lower Limb

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The mental health problems and needs of older people following lower-limb amputation

Reviews in Clinical Gerontology ◽

10.1017/s0959259807002171 ◽

2006 ◽

Vol 16 (2) ◽

pp. 155-163 ◽

Cited By ~ 6

Author(s):

Wendy Briggs

Keyword(s):

Mental Health ◽

At Risk ◽

Older People ◽

Lower Limb ◽

Mental Health Problems ◽

Traumatic Injury ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Anecdotal Evidence ◽

The Past

In the past, most amputees have been veterans of war or other younger people who have sustained traumatic injury. There are now an increasing number of older people undergoing lower-limb amputation, most commonly because of vascular problems. Anecdotal evidence suggests that there is a lack of support for patients facing limb amputation, and a lack of recognition from staff that these patients may be at risk of ongoing psychological problems following the procedure.

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The effect of cognitive impairment on prosthesis use in older adults who underwent amputation due to vascular-related etiology: A systematic review of the literature

Prosthetics and Orthotics International ◽

10.1177/0309364617695883 ◽

2017 ◽

Vol 42 (2) ◽

pp. 144-152 ◽

Cited By ~ 5

Author(s):

Daniel Joseph Lee ◽

Matthew C. Costello

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Outcome Measures ◽

Lower Limb ◽

Clinical Decision Making ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Review Of The Literature

Background:Older adults with amputations secondary to vascular etiologies may additionally present with cognitive impairment. Cognition plays an important role in the adoption of a prosthetic limb, although the degree and type of impact are debated. Previous literature reviews have not been directed at the specific population of older adults who underwent vascular-related lower limb amputation.Objectives:First, to assess extant literature for relationships between cognitive function and prosthesis-related outcomes in older adults who underwent lower limb amputation for vascular-related etiologies. Second, to perform a critical analysis of prosthesis-related outcomes and cognitive assessments performed in the studies.Study design:Systematic literature review.Methods:A systematic review of the literature was performed in databases using keyword combinations. A total of nine articles were selected to be included in this review.Results:Seven of the nine included studies found a relationship between decreased cognitive function and reduced performance on a prosthesis-related outcome. There were eight different prosthesis-related outcome measures, with only one study utilizing a comprehensive outcome measure.Conclusion:Cognitive impairment can negatively impact successful prosthesis use in older adults with lower limb amputation secondary to vascular complications. Future studies should utilize comprehensive outcome measures that represent the multifaceted constructs of cognition and prosthesis use.Clinical relevanceCognitive assessment of older adults who have undergone lower limb amputation secondary to diabetes related complications or vascular disease can be used to inform clinical decision-making. Clinicians should consider selecting prosthesis-related outcome measures that capture the full breadth of prosthesis use when evaluating patients with cognitive impairment.

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BILATERAL LOWER LIMB AMPUTATION — AN EXERCISE IN REHABILITATION1 1Received February 1971.

Australian Journal of Physiotherapy ◽

10.1016/s0004-9514(14)61105-3 ◽

1971 ◽

Vol 17 (2) ◽

pp. 41-46

Author(s):

Donald Caine ◽

Helen Dalgleish

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Bilateral Lower Limb

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Poster 82: Foot Drop-A Complication Following Contralateral Lower Limb Amputation: A Case Report

PM&R ◽

10.1016/j.pmrj.2009.08.100 ◽

2009 ◽

Vol 1 ◽

pp. S139-S139

Author(s):

SriKrishna Chandran ◽

Lauren Shapiro

Keyword(s):

Case Report ◽

Lower Limb ◽

Lower Limb Amputation ◽

Foot Drop ◽

Limb Amputation

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Global Position Sensing and Step Activity as Outcome Measures of Community Mobility and Social Interaction for an Individual With a Transfemoral Amputation Due to Dysvascular Disease

Physical Therapy ◽

10.2522/ptj.20120527 ◽

2014 ◽

Vol 94 (3) ◽

pp. 401-410 ◽

Cited By ~ 17

Author(s):

Arun Jayaraman ◽

Sean Deeny ◽

Yochai Eisenberg ◽

Gayatri Mathur ◽

Todd Kuiken

Keyword(s):

Case Report ◽

Social Interaction ◽

Outcome Measures ◽

Lower Limb ◽

Activity Monitor ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Transfemoral Amputation ◽

Position Sensing ◽

Community Mobility

Background and Purpose Community mobility of individuals following lower limb amputation is highly variable and has a great impact on their quality of life. Currently, clinical assessments of ambulatory ability and motivation influence prosthetic prescription. However, these outcome measures do not effectively quantify community mobility (ie, mobility outside of the clinic) of individuals with an amputation. Advances in global positioning systems (GPSs) and other wearable step-monitoring devices allow for objective, quantifiable measurement of community mobility. This case report will examine the combined use of a GPS unit and a step activity monitor to quantify community mobility and social interaction of an individual with transfemoral amputation due to dysvascular disease. Case Description A 76-year-old woman with a unilateral transfemoral amputation due to vascular disease carried a commercial GPS unit and step activity monitor to quantify her community mobility and social interaction every day over a period of 1 month. The step activity monitor was affixed to her prosthesis. The patient used a wheelchair as well as her prosthesis for everyday mobility. Outcome Information from the GPS unit and step activity monitor provided quantitative details on the patient's steps taken in and out of the home, wheelchair use, prosthesis use, driving trips, and time spent on social and community trips. Discussion This case report describes a potential clinical measurement procedure for quantifying community mobility and social interaction of an individual with lower limb amputation. Future efforts are needed to validate this measurement tool on large sample sizes and in individuals with different mobility levels. Additionally, automatization of data analysis and technological approaches to reduce compromised GPS signals may eventually lead to a practical, clinically useful tool.

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