Pre-Prosthetic Rehabilitation in Post-operative Transtibial Amputation Patient: A Case Report

Background: Amputation is that the removal of injury by, undue constriction, surgical condition or surgery of associate degree extremity. Below-knee amputation (BKA) may be a transtibial amputation that involves separating the foot, ankle joint, and distal shinbone and leg bone from associated soft tissue structures. This surgical treatment carries wide morbidity, but, provided adequate indications; it remains a therapeutic tool with very important clinical price and generally life-saving importance. The majority of transtibial amputations is due to peripheral vascular disease or lower limb circulation disease (60 percent -70 percent).The main goal of rehabilitation procedures is to generally increase healthy and impaired limb strength, patient flexibility, cardiovascular ability, and equilibrium. . Health care is burdened by comprehensive recovery and long-term care. Mobility is essential to independence recovery; however, the effect of multiple comorbidities in this patient population will render mobility recovery a particularly difficult task Clinical Finding: An 65 year old male complains of pain in right foot since 3 month. Swelling was appeared and skin over the black lower leg turned black with foul smelling discharge from foot. He was diagnosed with right lower limb gangrene and referred to Physiotherapy department for prosthetic prescription and rehabilitation after trans tibial amputation. Diagnosis: Duplex colour Doppler study of left lower limb show triphasic flow in CIA, EIA, IIA, SFA, POP, ATA, PTA arteries of right lower limb, dampened flow noted in right dorsalis pedis artery and atherosclerosis wall thickening in the arteries of right lower limb. Conclusion: This case report provides patient with inclusive recovery which help to decide on a patient’s suitability for a prosthetic limb prosthetic fitting.

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Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽

10.1024/0301-1526/a000876 ◽

2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Marina Di Pilla ◽

Stefano Barco ◽

Clara Sacco ◽

Giovanni Barosi ◽

Corrado Lodigiani

Keyword(s):

Systematic Review ◽

Case Report ◽

Lower Limb ◽

Limb Ischemia ◽

Acute Limb Ischemia ◽

Review Of The Literature ◽

Heparin Induced Thrombocytopenia ◽

Lower Limb Ischemia ◽

Vein Thrombosis ◽

Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

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Lower limb ischemia, the cause arising from difficult healing wounds – a case report

Leczenie Ran ◽

10.15374/lr2015008 ◽

2015 ◽

Vol 12 (2) ◽

pp. 59-67

Author(s):

Paulina Mościcka ◽

Maria T. Szewczyk ◽

Elżbieta Hancke ◽

Justyna Cwajda-Białasik ◽

Paweł Wierzchowski ◽

...

Keyword(s):

Case Report ◽

Lower Limb ◽

Limb Ischemia ◽

Lower Limb Ischemia ◽

Healing Wounds

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Management of a Complex Lower Limb Open Fracture in a Teenage Patient: A Case Report

Wound Management & Prevention ◽

10.25270/owm.2018.5.4752 ◽

2018 ◽

Vol 64 (5) ◽

pp. 47-52

Author(s):

Davor Mijatovic ◽

Sanda Smud Orehovec ◽

Tomislav Dapic ◽

Vilena Vrbanovic Mijatovic

Keyword(s):

Case Report ◽

Lower Limb ◽

Open Fracture

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Importance of Avasthiki Chikitsa in Pakshaghata and its complications: A Clinical Case Report

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8251 ◽

2017 ◽

Vol 2 (3) ◽

Author(s):

Vishwanath S. Wasedar ◽

Shilpa S. Biradar

Keyword(s):

Case Report ◽

Lower Limb ◽

Life Style ◽

Occipital Lobe ◽

Blood Parameters ◽

Effective Control ◽

Research Centre ◽

Successful Case ◽

Diet And Exercise ◽

Loss Of Strength

Purpose: Life style disorders demand a strict regimen throughout one’s life among which Hypertension and Diabetes Mellitus are common. Hence the treatment aims an effective control along with Life style modification. The negligence towards the prescribed life style regimen would lead to many complications among which stroke are most prominent and the prevalence in India is 29%. Though the patient is under strict Anti hypertensive medications still one day he/she will land up in stroke hampering his rest of precious life. Aim: With this understanding a successful case report is presented to highlight the importance of Avasthiki Chikitsa with life style modification in controlling Hypertension and treating Pakshaghata from the root level. Materials and Methods: A 74 years old female patient, known case of HTN and DM was brought on a stretcher to the Panchakarma OPD of KLEU Ayurveda Hospital and Research Centre with the complain of loss of strength in left upper and lower limb associated with inability to speak since 9 days. Her MRI suggested Left Hemiplegia with B/L cerebellar hemorrhagic infract in occipital lobe. Initially treatment commenced with Shiromarmaghata Chikitsa with Shamanoushadhi along with modern medication which the patient had been advised. Later on when the patient started to improve in her blood parameters allied science medications were tapered and gradually stopped excluding her routine medication. After the clearance of Avarana, Panchakarma therapies were administered sequentially at various stage with a meticulous diet and exercise. Results: After 22 days of treatment Diabetes and Hypertension were under control, patient was able to walk with minimal support and speech also improved. Conclusion: A well planned diet along with Ayurvedic therapies based on the Awastha provides encouraging results in treating HTN, DM and Pakshaghata.

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Effect of Punarnavadi Mandoor and Shiva Gutika in Acute Deep Vein Thrombosis - A Case Report

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i4.9371 ◽

2017 ◽

Vol 2 (4) ◽

Author(s):

Wasedar Vishwanath S. ◽

Pusuluri YVSM Krishna ◽

Dani Harshikha

Keyword(s):

Lower Limb ◽

Blood Clot ◽

Acute Case ◽

Vein Thrombosis ◽

Oral Medications ◽

Doppler Study ◽

Brown Discoloration ◽

Left Lower Limb ◽

Life Threatening ◽

Deep Vein

Objectives: To minimise the dose of Anti-platelet drugs and to treat the acute case of DVT through Ayurvedic oral medications. Methods: The present diagnosed case of DVT approached to OPD of KLE BMK Ayurveda Hospital with a complaints of swelling and pain in the calf muscle of the left lower limb associated with reddish brown discoloration in the foot and occasionally nasal and gum bleeding was treated consequently for 5 months with Punarnavadi Mandoor and Shiva Gutika orally. Results: There is significant decrease in the symptoms of DVT and also major changes seen in Venous Colour Doppler study of the left lower limb. Conclusion: Acute DVT is caused by a blood clot in a deep vein and can be life threatening as it may leads to serious complication like pulmonary embolism which can be cured through Ayurvedic oral medications.

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Prevalence of Peripheral Vascular Disease in Diabetic Foot Infections and its Effect on Management Outcome

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v38i1.44683 ◽

2019 ◽

Vol 38 (1) ◽

pp. 12-17

Author(s):

Farah Nobi ◽

Syed Al Nahian ◽

Afrin Sultana ◽

Rokhsana Sarmin ◽

Ayesha Rahman ◽

...

Keyword(s):

Vascular Disease ◽

Peripheral Vascular Disease ◽

Lower Limb ◽

Diabetic Foot ◽

Tertiary Care ◽

Peripheral Vascular ◽

Tertiary Care Centre ◽

Term Care ◽

Diabetic Foot Infection ◽

Diabetic Foot Infections

Background: Foot infection is a common problem affecting diabetics. Ischemia is a major factor contributing to progress and morbidity of the disease. The prevalence of peripheral vascular disease is higher in diabetics with faster progression. Aim: This study aimed to observe the prevalence of peripheral vascular disease in patients with diabetic foot infections presenting to this tertiary care centre. Methods: This prospective observational study evaluated 250 patients with diabetic foot infection admitted to Ibrahim Medical College and BIRDEM General Hospital, Dhaka, from 1st January 2015 to 31st December 2015.Total 72 patients were selected for Duplex study of lower limb vessels, Ankle Brachial Pressure Index (ABPI) and Pulse oxymetrywhich established the diagnosis of peripheral vascular disease and all patients were treated according to the standard protocol. Results: Of the 72 patients peripheral vascular disease was found in 25 patients (34.7%) and majority of them (88%) had distal below the knee vessel stenosis. There was significant correlation with older age (75%) and history of tobacco use (64%). The clinical presentations and outcomes such as hospital stay, healing time, pain were worse in individuals with peripheral vascular compromise on Duplex study of lower limb vessels, ABPI and pulse oxymetry. Conclusion: In this study we observed that significant number of diabetics presenting with foot infections have underlying peripheral vascular disease .The patients might not all be symptomatic or show obvious signs of PVD but need to be investigated for the same. Early detection of peripheral vascular disease in patients presenting with diabetic foot infection, using Duplex study,ABPI and Pulse oxymetrywith routine clinical and laboratory assessment can be of great value in long term care of these individuals. J Bangladesh Coll Phys Surg 2020; 38(1): 12-17

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Necrotizing Fasciitis Occurred in the Lymphedematous leg

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211023030 ◽

2021 ◽

pp. 153473462110230

Author(s):

Hisako Hara ◽

Makoto Mihara ◽

Takeshi Todokoro

Keyword(s):

Case Report ◽

Necrotizing Fasciitis ◽

Lower Limb ◽

Gynecologic Cancer ◽

Vital Signs ◽

Ethics Committee ◽

Secondary Lymphedema ◽

Delayed Treatment ◽

Institutional Ethics ◽

Life Threatening

Lymphedema is a chronic edema that sometimes occurs after treatment of gynecologic cancer, and cellulitis often occurs concomitantly with lymphedema. On the other hand, necrotizing fasciitis (NF) is a relatively rare, but life-threatening disease. The symptoms in cellulitis and NF are very similar. In this case report, we describe a case in which the diagnosis of NF in a lymphedematous limb was difficult. A 70-year-old woman had secondary lymphedema in bilateral legs and consulted our department. On the first day of lymphedema therapy, the patient complained of vomiting, diarrhea, and fever (37.7 °C) without local fever in the legs. She was diagnosed with acute gastroenteritis. On the next day, swelling and pain in her left leg occurred and her blood pressure was 59/44 mmHg. She was diagnosed with cellulitis accompanied by lower limb lymphedema and septic shock. On the second day, blisters appeared on the left leg, and computed tomography showed NF. We performed debridement under general anesthesia and her vital signs improved postoperatively. Streptococcus agalactiae (B) was detected in blood culture, and we administered bixillin and clindamycin. Postoperatively, necrosis in the skin and fat around the left ankle gradually spread, and it took 5 months to complete epithelialization. The diagnosis was more difficult than usual NF because patients with lymphedema often experience cellulitis. Clinicians should always think of NF to avoid mortality due to delayed treatment. This case report was approved by the institutional ethics committee.

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