Psychological Rehabilitation on a Patient with Breast and Arm Amputation: A Case Report

We define amputation as a removal of totally or partial part of an organ. Amputations can be caused by chronic diseases as cancer, infection and diabetes, or by a traumatic accident. Where, we discuss the differences between the two types of amputation. This paper is a case report on an amputee patient, the consequences in short e long term. We suggest possible interventions for psychological professionals and multidisciplinary healthcare team. Also, we discuss the lack of academic production about traumatic amputations.

Myoelectric prosthesis: a potential emerging therapeutic in restoring function post-arm amputation complicated by necrotizing fasciitis

A literature search confirmed no previous cases of an arm amputation secondary to necrotizing fasciitis (NF) being successfully treated with a myoelectric prosthesis. This report explores a case of a 55-year-old right-handed male with flexor tenosynovitis infection of the hand after a small laceration. Following infectious disease consult of the infection, a diagnosis of NF was made. Broad-spectrum antibiotics were initiated but the infection worsened after 12 hours. Two debridements with wound vacuum were undertaken in the next 48 hours. After further patient deterioration, a distal left forearm amputation was undertaken. The patient fully recovered and then underwent occupational therapy training with a myoelectric prosthesis to restore hand function. The patient was seen for follow-up 3, 6, 12 and 24 months after amputation. At 2-year follow-up, the patient was continuing rehabilitation with an occupational therapist to acclimate to the prosthesis with some gain of function in gross movement.

Admiral Nelson’s illnesses and injuries

Horatio Nelson is one of the greatest English heroes. His key exploits at the battles of the Nile and Trafalgar, which led to Britain’s maritime supremacy, are well known and celebrated in the 5.5m statue at the summit of Nelson’s column in Trafalgar Square, London. The statue also showcases his most famous injuries, the injury to his right eye and arm amputation. However, as well as these he had a number of other battle injuries and afflictions including recurrent malaria, yellow fever, scurvy, tuberculosis and dysentery, which, although he bore with stoicism, may have affected his professional performance at different times in his career. The exact cause of his death was probably a combination of blood loss, lung injury and spinal shock.

Analysis of Swimming Motion for a Swimmer with Unilateral Transradial Deficiency to Develop Better Training Paddles

Devices for swimmers with arm amputation/deficiency have not been developed a lot and therefore many improvements can be realized. Although swimmers often use paddles during training, paddles on the market are basically for swimmers without amputation/deficiency. The objective of this study was to analyze the swimming motion of a swimmer with unilateral transradial deficiency and to obtain the findings for development of better training paddles. The crawl stroke was filmed for a swimmer with unilateral transradial deficiency. The body geometry as well as the joint motion based on the filmed images were put into the swimming human simulation model SWUM, and a simulation was conducted. From the simulation, the coordination and thrusts of both limbs were obtained and fully discussed. Overall, significant asymmetry between the intact and deficient limbs was found. It was also found that the deficient limb contributed to the propulsion only for 7% of the intact limb.

Remapping in cerebral and cerebellar cortices is not restricted by somatotopy

A fundamental organizing principle in the somatosensory and motor systems is somatotopy, where specific body parts are represented separately and adjacently to other body parts, resulting in a body map. Different terminals of the sensorimotor network show varied somatotopic layouts, in which the relative position, distance and overlap between body-part representations differ. Since somatotopy is best characterized in the primary somatosensory (S1) and motor (M1) cortices, these terminals have been the main focus of research on somatotopic remapping following loss of sensory input (e.g. arm amputation). Cortical remapping is generally considered to be driven by the layout of the underlying somatotopy, such that neighboring body-part representations tend to activate the deprived brain region. Here, we challenge the assumption that somatotopic layout restricts remapping, by comparing patterns of remapping in humans born without one hand (hereafter, one-handers, n=26) across multiple terminals of the sensorimotor pathway. We first report that in the cerebellum of one-handers, the deprived hand region represents multiple body parts. Importantly, the representations of some of these body parts do not neighbor the deprived hand region. We further replicate our previous finding, showing a similar pattern of remapping in the deprived hand region of the cerebral cortex in one-handers. Finally, we report preliminary results of a similar remapping pattern in the putamen of one-handers. Since these three sensorimotor terminals (cerebellum, cerebrum, putamen) contain different somatotopic layouts, the parallel remapping they undergo demonstrates that the mere spatial layout of body-part representations may not exclusively dictate remapping in the sensorimotor systems.Significance StatementWhen a hand is missing, the brain region that typically processes information from that hand may instead process information from other body-parts, a phenomenon termed remapping. It is commonly thought that only body-parts whose information is processed in regions neighboring the hand region could “take up” the resources of this now deprived region. Here we demonstrate that information from multiple body-parts is processed in the hand regions of both the cerebral cortex and cerebellum. The native brain regions of these body-parts have varying levels of overlap with the hand region across multiple terminals in the sensorimotor hierarchy, and do not necessarily neighbor the hand region. We therefore propose that proximity between brain regions does not limit brain remapping.

A 50-year-old man with desmoid-type fibromatosis of upper extremity

This case study describes a 50-year-old man with a desmoid tumor of upper extremity, which had to be resected concomitant with the left arm amputation at middle third of the humerus. The course was initially stable, but evolved with aggressive infiltration of local soft tissues. During the watchful waiting time, three biopsies were done before establishing the diagnosis. Plain X-ray, magnetic resonance and positron emission tomography were the exams utilized. The authors emphasize diagnostic and management challenges involving this rare condition. Case reports can stimulate further studies to get additional knowledge about this rare entity.