[Lower limb amputations and rehabilitation]

Physiotherapy Rehabilitation for Above-Knee Amputation Secondary to Infected External Fixation: A Case Report

This case study examines the total physiotherapy care of a 50-year-old male patient, who had a right-sided displaced distal tibia and fibula fracture, a talus fracture due to a road traffic accident, and an above-knee amputation due to a serious infection. Enhancing muscle strength, reducing pain from phantom limbs, avoiding problems, maintaining range of motion, increasing endurance, and promoting functional independence in the postoperative period were the main goals of the patient's rehabilitation. The recovery plan included an intensive four-week program of physiotherapy care. The regimen included a variety of interventions, such as pain management, edema control, wound healing techniques, range of motion (ROM) exercises, muscle strengthening activities, mobility and transfer exercises, cardiovascular endurance training, psychosocial support, education on prosthetic use, and independence in daily living activities. ROM measures, manual muscle testing, and functional independence measure scores were used to evaluate the patient's improvement. The patient's physical health and level of functional independence both exhibited significant improvements, according to the statistics. Following treatment, the patient's ROM, muscle strength, and overall functional independence all improved. The study highlights the positive impacts of physical therapy interventions on the patient's quality of life, mobility, and self-sufficiency following the amputation and subsequent recovery. These findings support the patient's transition to a more self-sufficient and active lifestyle by providing valuable insights into the efficient use of physiotherapy and the comprehensive post-amputation treatment plan.

State-sponsored institute-based provision of advanced artificial limbs for rehabilitation of amputees

Introduction: Amputation is a painful functional experience and optimal rehabilitation of an amputee is a team effort. Functional restitution depends on many factors including the type of prosthesis available. We report our experience of providing advanced artificial limbs at free of cost to the underprivileged through a state-sponsored pilot initiative. Material and methods: This is a retrospective cohort study of amputees who have been rehabilitated with advanced artificial limbs through the Department of Orthopaedics at Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India from the years 2017 to 2021. Prostheses were procured through rate contract and monitory support was provided by the state. Evaluation, fitment and functional restitution were supervised by the orthopaedic surgeons to the utmost satisfaction of the amputees. Results: A total of 136 subjects received 142 advanced artificial limbs. Out of 136 subjects, 130 received unilateral and 6 subjects received bilateral prosthesis. Ninety-two percent (n  =  125) were men and 8% (n  =  11) were women. Eighty-eight (n  =  125) were lower limb prosthesis and 12% (n  =  17) were upper limb prosthesis. All the amputees fitted with advanced artificial limbs were highly satisfied at the end of the procedure and were confident of independent living. Conclusion: Appropriate rehabilitative measures are required for amputees to lead an independent life. Paucity of institutional support and monitory challenges preclude them from advanced prosthesis. State-sponsored, institute-based supply of advanced artificial limbs at free of cost to the beneficiaries is a replicable and feasible option for optimal rehabilitation of amputees with appropriate prosthesis.