J Korean Phys Ther.  2018 Oct;30(5):199-203. 10.18857/jkpt.2018.30.5.199.

Functional Improvement Following Revision Surgery in a Patient with the Dual Disability of a Complicated Residual Limb and Contralateral Hemiplegia: A Case Report

• Byun KH
• Yang DS
• Jang BH

• KMID: 2434858
• DOI: http://doi.org/10.18857/jkpt.2018.30.5.199

Abstract

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

Keyword

Disability; Hemiplegia; Amputation; Surgery

MeSH Terms

Amputation
Ankle
Canes
Extremities*
Foot Orthoses
Hemiplegia*
Humans
Hyperplasia
Lower Extremity
Neuroma
Putaminal Hemorrhage
Stroke
Walking