A case of delay in lower leg prosthesis creation due to skin conditions after lower leg amputation  

―A case approached by co-medical staff to acquire walking ability―

Authors

  • 小川 祐来
  • 平野 恵健 日本医療科学大学
  • 大森 まいこ
  • 高橋 航世
  • 今村 健太郎

Keywords:

Lower leg amputation, Prosthetics and orthotics, Convalescence rehabilitation ward

Abstract

This case involves a 44-year-old man whose legs were run over by a continuous track. After right invasive fixation and lower left leg amputation, epithelialization at the donor site and stump was delayed. In response to this, rehabilitation aimed at returning home was conducted. As a lower leg prosthesis could not be created, considering the condition of the donor site and left stump, we contemplated that the patient should acquire the ability to move with crutches during the hospitalization period. However, we considered the patient's desire for a limb prosthesis (walking) as well as his post-discharge environment, and in order to make the prosthesis according to the condition of the left stump, the attending therapist, primary physician, and nurse closely collaborated to conduct a gradual rehabilitation for the patient to acquire the ability to walk, while regularly confirming the condition of the donor site and left stump. Consequently, epithelialization was confirmed in the donor site and left stump, which allowed the creation of a prosthesis. The patient was able to walk and expand the range of his activity, ultimately allowing the patient to return home. Despite the poor condition of the donor site and stump, the multidisciplinary approach and gradual rehabilitation program modelled on the patient’s condition likely led to the early acquisition of walking ability after prosthesis creation. Moreover, this also led to a safe post-discharge environment and expansion of the patient's range of activity.

Author Biography

平野 恵健, 日本医療科学大学

職位:准教授  

学位:博士(理学療法学)首都大学東京大学院 人間健康科学研究科

資格:理学療法士 ・ドイツ徒手医学認定セラピスト ・3学会合同呼吸療法認定士

専門分野:整形外科学、義肢装具学

研究テーマ: 理学療法学における臨床研究

 

業績:

  1. Yoshitake Hirano, et al: Development of a prognostic scale for severely hemiplegic stroke patients in a rehabilitation hospital. Clin Neurol Neurosurg. 2017;158(7):108-113.
  2.  Yoshitake Hirano, et al: Prediction of Independent Walking Ability for Severely Hemiplegic Stroke Patients at Discharge from a Rehabilitation Hospital. J Stroke Cerebrovasc Dis. 2016 ;25(8):1878-1881.
  3.  Yoshitake Hirano, et al:Prognosis and classification of severely hemiplegic stroke patients in a rehabilitation hospital. J Phys Med Rehabil 2017, 5: 397(DOI 10.4172/2329-9096.1000397). 
  4. Yoshitake Hirano, et al: The effect of voluntary training with family participation on early home discharge in patients with severe stroke at a convalescent rehabilitation ward. Eur Neurol. 2012;68(4):221-228.

 

他37編、Proceedings 4編、学会発表(国内・国外)117本

 

競合研究費の採択

公益財団法人 ひと・健康・未来研究財団 医学研究助成金(2015)

公益財団法人 大同生命厚生事業団 地域保健福祉研究助成金(2011)

 

受賞:第59回日本循環代謝学会学術集会 優秀ポスター賞(2016)

 

Published

2022-02-03

Issue

Section

Reports