Professor Universidad Nacional de Colombia Bogotá, Distrito Capital de Bogota, Colombia
Case Diagnosis: In Colombia, many amputee patients derive from traffic accidents, several of them previously totally independent. In rehabilitation medicine we seek how to socially integrate the individual, considering their residual functionality and the disability generated after an injury that affects the musculoskeletal system.
Case Description: This is a 60-year-old patient who in July 2019 presented a severe injury to the lower limbs in a traffic accident, when she was hit by a truck. She presented severe crushing trauma to the lower limbs. A transfemoral amputation of the right lower limb was performed and the left required amputation of the hallux and multiple surgeries on the foot, despite which the foot presents severe and rigid deformity in flexion and inversion that does not allow walking and achieves 30 seconds of support with pain on the forefoot of the left lower limb. It also presents a painful phantom limb. She was sent for evaluation to formulate a prosthesis but due to the residual deformity of the left foot it was not possible. As a result of this, other options had to be evaluated and finally a wheelchair was ordered, with which the patient copes well.
Discussions: We must evaluate the functionality of an amputee patient, both before and after the situation that led to that condition. Not every amputee patient necessarily requires the formulation of a prosthesis. Your independence can be improved if we propose a suitable rehabilitation program.
Conclusions: In this case, we consider that the use of a custom-made wheelchair and a training program with which a better objective was achieved and the management of phantom limb pain and follow-up by our specialty continued. This consideration was explained to the patient, who understood and accepted.