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Amputation prosthesis orthosis

Sanjay Maurya, N Srinath, P S Bhandari
Background: Mine blast injuries of foot are devastating injuries that result in composite tissue loss or amputations. Negative pressure wound therapy has helped in the management of such combat-related wounds. The aim of this study was to report experiences gained in managing such injuries at a tertiary care center. Methods: 17 combatants who sustained mine blast injuries were included in this study. Severity of foot injury was assessed as per Foot and Ankle Severity Score...
October 2017: Medical Journal, Armed Forces India
Thangavelu Senthilvelkumar, Bobeena R Chandy
INTRODUCTION: This is a single-subject case report. The objective is to describe the unique rehabilitation outcome of an individual with motor complete T12 paraplegia and a right transtibial amputation. This study was conducted at the Department of Physical Medicine and Rehabilitation of Christian Medical College in India. CASE PRESENTATION: A 42-year-old policeman presented to our rehabilitation centre with motor complete T12 paraplegia and right transtibial amputation, 3 months following a road traffic accident...
2017: Spinal Cord Series and Cases
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
May 2017: Gait & Posture
Marie Laberge-Malo, Reggie C Hamdy, Laurent Ballaz, Audrey Parent, Annie Pouliot
OBJECTIVE: Toe filler combined to ankle-foot orthosis (AFO) can be used to improve gait after a partial foot amputation. The AFO supports the plantar aspect of the foot, and the toe filler gives a longer lever arm that helps for pivoting over the lost metatarsals. However, the AFO type can influence gait parameters. The objective of this study case was to evaluate the effect of prosthesis with toe filler combined to: - an articulated AFO; - a fixed carbon-fiber AFO on gait. PATIENTS AND METHODS: A gait analysis was practiced on a 20-year-old male with a partial foot amputation...
September 2016: Annals of Physical and Rehabilitation Medicine
H F Maqbool, M A B Husman, M I Awad, A Abouhossein, A A Dehghani-Sanij
Events and phases detection of the human gait are vital for controlling prosthesis, orthosis and functional electrical stimulation (FES) systems. Wearable sensors are inexpensive, portable and have fast processing capability. They are frequently used to assess spatio-temporal, kinematic and kinetic parameters of the human gait which in turn provide more details about the human voluntary control and ampute-eprosthesis interaction. This paper presents a reliable real-time gait event detection algorithm based on simple heuristics approach, applicable to signals from tri-axial gyroscope for lower limb amputees during ramp ascending and descending...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Shreshth Dharm-Datta, J McLenaghan
The Winston Churchill Memorial Trust, established in 1965, funds Travelling Fellowships and both authors visited hospitals in Germany, Canada and the USA regarded as centres of excellence with expertise in the early care, reconstruction and rehabilitation of the combat casualties of our NATO Allies, as recipients of these Fellowships. This article presents some of the lessons learnt in the field of musculoskeletal trauma and rehabilitation from the Canadian and US military medical systems. In trauma, there were significant differences in wound debridement policy, use of external fixators for fractures, primary use of circular frames for open tibial fractures and a far more liberal use of bone morphogenetic protein in fracture treatment...
June 2013: Journal of the Royal Army Medical Corps
Susan Ewers Spaulding, Tzurei Chen, Li-Shan Chou
BACKGROUND: Little evidence exists for the orthotic management for individuals diagnosed with diabetic neuropathy and partial foot amputation. OBJECTIVE: This pilot study examined differences in balance and pressure distribution while individuals wore foot orthoses inside shoes (BA) and this same orthosis combined with an above-ankle (AABA) orthosis. STUDY DESIGN: Within-group repeated measures crossover design. METHODS: Participants with transmetatarsal amputation were assessed during randomized visits with the two interventions...
June 2012: Prosthetics and Orthotics International
Theresa Y Wang, John P Dormans, Benjamin Chang
PURPOSE: Limb salvage in bone sarcomas requires resection and joint and soft-tissue reconstruction. Suboptimal coverage can lead to prosthesis infection, subsequent hardware exposure, or loss with eventual amputation. In the pediatric sarcoma population, it is essential to not only have viable soft-tissue coverage but one that minimizes donor site morbidity and maximizes function and growth over time. METHODS: This is a retrospective review of all sarcoma patients with primary gastrocnemius and soleus muscle flap coverage of modular knee endoprosthesis over the 10-year period between 1997 and 2007...
November 2012: Annals of Plastic Surgery
Yasushi Toge, Fumihiro Tajima, Nozomu Narikawa, Takaki Honda, Munehito Yoshida, Jeffrey R Basford
Osteosarcomas require aggressive medical and surgical treatments that frequently result in impaired musculoskeletal function. Amputation was formerly a treatment of choice for patients with sarcomas in an extremity. Although there has been controversy over the relative benefits of amputation and limb sparing, it is undeniable that limb sparing is becoming more common and that it frequently leaves a person with a limb whose function is limited. This is particularly true in the lower extremities, where pelvic and proximal femoral resections may lead to severe weight-bearing and mobility limitations...
July 2006: Archives of Physical Medicine and Rehabilitation
Robert A Bedotto
Biomechanical treatment is like a jigsaw puzzle with two complex counterparts having many pieces. The physical and mechanical components are equally important and cannot be separated from each other. The patient with a prosthesis or an orthosis represents a biomechanical system; total treatment is essential. All of the pieces to the puzzle must be used to complete the picture. Given the present structure of the educational system, there is a separation of disciplines necessary to provide one truly biomechanical treatment...
February 2006: Physical Medicine and Rehabilitation Clinics of North America
A Koller, U Hafkemeyer, R Fiedler, H H Wetz
QUESTION: Neurogenic osteoarthropathy often results in a debilitating deformity of the foot which can not be handled conservatively. Indications for surgery are recurrent ulcers, deep tissue infection and decompensated statics with progressing deformity. External fixation as a possible method of correction has to show its efficiency and methods. METHODS: Between 1997 and 2003, 65 feet which could be examined retrospectively, were operated for neuroarthropathy in 21 women and 43 men...
September 2004: Der Orthopäde
A Koller, R Fiedler, H H Wetz
The localization of neurogenic osteopathy in the hindfoot often results in deformities which cannot be corrected by conservative methods. Indications for operation are recurring ulcers, deep infection, and reduced stability with progressive deformity. The aim of this study was to ascertain whether external fixation enables reestablishment of foot stability even when the osteoarthropathic processes have not entirely ceased. A bilaterally mounted Hoffman 2 fixator was used for open repositioning and restabilization on 14 patients with osteoarthropathy of the hindfoot: 12 had diabetes mellitus and 13 had florid processes...
April 2001: Der Orthopäde
E Sobel, C J Japour, R J Giorgini, S J Levitz, H L Richardson
The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58...
January 2001: Journal of the American Podiatric Medical Association
V A Trishkin, N V Beliak, K K Shcherbina, V A Kochnev, K S Egorov, E V Trishkina
An analysis of results of treatment and prostheses of 89 patients with malignant tumors of the upper extremities and shoulder girdle has shown that among the tumors there were osteogenous sarcomas, chondroid sarcomas, nonclassified sarcomas, reticulosarcomas, angiosarcoma, fibrohistocytic sarcoma, Euring's sarcoma, solitary myeloma, giant cells tumors. Interscapular-thoracic amputations were performed in all the patients. The overall survival rate was (28.6 +/- 8.3)%. An orthosis and a modified prosthesis developed at the research institute of prostheses named after prof...
2000: Vestnik Khirurgii Imeni I. I. Grekova
J C Shin, C Park, D Y Kim, Y S Choi, Y K Kim, Y J Seong
Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side...
August 2000: Yonsei Medical Journal
W Wenz, M Schweinfurth, D Wenz
Children with limb deficiencies or amputations of the lower extremities should be enabled to stand or walk according to their state of development, because standing and walking are among the most important preconditions for the best possible integration. Supplying them with a prosthesis, orthosis and orthoprosthesis is therefore indispensable for rehabilitation. While a prosthesis replaces parts of the extremities, an orthosis stabilizes the existing extremity. Orthoprostheses compensate longitudinal malformations, have a supporting effect, allow growth to be controlled and compensate for shortening...
July 1998: Pediatric Rehabilitation
W Wenz, D Wenz, L Döderlein
In rehabilitation of children and adolescents with lower limb deficiencies it is very important that the medical team taking care of the patient works out a treatment plan. Responsible cooperation with the parents is of utmost importance, the focus of all efforts is, of course, the handicapped child. The aims of rehabilitation are illustrated by examples demonstrating the course of successful rehabilitation of children and adolescents with damaged limbs. Equally, the psychological situation of the parents and child is taken into consideration...
August 1998: Die Rehabilitation
E A Moberg-Wolff
A 15-year-old boy presented with a severe fluctuating foot and ankle dystonia resulting from a basal ganglia insult at the age of 4. This followed an embolic event related to an undiagnosed prolapsed mitral valve. Functionally, the patient was ambulatory with rocker bottom crutches and an ankle-foot orthosis, but there were periods of up to a year when pain and increased dystonic deformity required him to use a wheelchair. A new orthotic was made nearly every month because the orthotist could find no material that would withstand his tone without breaking, yet he could not ambulate without one...
May 1998: Archives of Physical Medicine and Rehabilitation
G Hirsch, M E McBride, D D Murray, D J Sanderson, I Dukes, M R Menard
Gait was analyzed in seven otherwise healthy males at least 11 mo after they had recovered from a traumatic unilateral transmetatarsal amputation incurred during the course of their usual occupation. All seven were fitted with a semirigid foot orthosis. Four were also fitted with a Chopart prosthesis. Gait was evaluated with forceplate measurements of ground reaction force during free walking, by clinical observation of such ambulation on videotape, and by the subjective impression of the men as obtained by a questionnaire...
July 1996: American Journal of Physical Medicine & Rehabilitation
E Cohen-Sobel, M A Caselli, J Rizzuto
The history and prosthetic difficulties of a patient with an unusual Chopart amputation variant have been presented. Although it is possible for the Chopart amputee to walk with just a shoe and filler, this patient does best with a formal prosthesis. The Chopart amputation, which has been surgically stabilized with Achilles tendon lengthening to prevent equinus contractures, can be fitted successfully with a lightweight circumferential plastic or silicone prosthesis or more traditionally with a solid ankle foot orthosis with filler...
October 1994: Journal of the American Podiatric Medical Association
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