A 22-year-old male who came in contact with a high-voltage wire, with entry point at the head and exit points at the ankles, presented with flaccid paraplegia and loss of sensation of bilateral lower extremities with no radiographic abnormalities. Several burn-related medical complications arose during the admission, as well as episodes of demotivation. Bilateral below the knee amputation was done because of extensive burn injuries of the lower extremities. The rehabilitation management for a patient with multiple disabilities needed to be tailored depending on the limitations and needs of the patient at a certain point in time. Despite the challenges, satisfactory results were achieved, through telerehabilitation and employing a multidisciplinary team approach.
Spinal Cord Injuries ; Amputation, Surgical

On July 4th 2002 at the Department of Trauma and Burn, Can Tho General Hospital, an accidental total amputation of the left forearm in a 14 years old child was replanted successfully. Micro-surgery was initiated 2 hours after injury and lasting for 7 hours. Immediate results showed good survival signs of the replanted forearm. Further surgery on the bone of the arm and skin transplantation was performed. Rehabilitation is on going to regain the function of the forearm.
Amputation ; Casts, Surgical ; Replantation ; surgery ; Therapeutics

Objectives: To determine the risk factors for recurrence and persistence of non-healing foot ulcers resulting in minor and major amputations. Methodology: This was an ambispective cohort analysis of persons with diabetic foot ulcers consulting at the diabetic foot clinic of East Avenue Medical Center. Data were analyzed through multiple logistic regression. Result: Two hundred sixteen patients with Type 2 Diabetes Mellitus and diabetic foot ulcers were included in the analysis; 50.9% were males and the mean age of the cohort was 55.8 ± 9.9 years. Outcomes of foot ulcers were: healed 44.5% (healed with no recurrence 30%, healed but with recurrence 14.5%) and not healed 55.5% (major amputation 11%, minor amputation, 21.5%, and persistently non-healing 23%). Multivariate logistic regression showed the following were independent risk factors for persistent non-healing ulcer: osteomyelitis (OR 66.5; CI 19.7, 217.8), smoking (OR 28.9; CI 6.8, 129.3, and peripheral arterial disease (PAD) (OR 56.8; CI 2.5, 877.2). Independent risk factors for ulcer recurrence were: plantar location of ulcer (OR 16.8; CI 6.8, 89.4), presence of more than one ulcer (OR 7.8; CI 3.6,31.6), and neuropathy (OR 11.2; CI 7.2, 19.9). For healed foot ulcers, mean healing time was 14 ± 3 weeks. Healing time was significantly reduced from 12 weeks to 4.5 weeks (p<0.001) if patients consulted earlier (within 4 weeks from sustaining an ulcer). Conclusion Only half (55%) of patients with diabetic foot ulcers consulting in a dedicated outpatient foot clinic had an adverse outcome of foot ulcers (major amputation 11%, minor amputation, 21.5%, and persistently non-healing ulcer 23%) while a small portion (14.5%) of patients had recurrent foot ulcers. Arterial obstruction, smoking, low hemoglobin, neuropathy, and osteomyelitis increase the likelihood of healing failure while the presence of multiple ulcers, plantar location of ulcers, and neuropathy increase the risk of ulcer recurrence.
Foot Ulcer ; Amputation, Surgical ; Peripheral Arterial Disease

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries

The coverage of large soft tissue defects in heel is a problem for surgical reconstruction. Various reconstructive materials are available depending on the location, size and depth of heel defect, but unique function of heel skin cannot be restored easily by means of reconstruction. We used prefabricated flap of the foot heel to cover heel defect in a child and obtained satisfactory clinical results.
Amputation ; Child ; Heel ; injuries ; surgery ; Humans ; Male ; Surgical Flaps

Laceration and amputation of the auricle due to external injuries are common because of its location. Several choices of reconstructive surgical procedure have been introduced for amputated auricle until now. Modified pocket method is known as the one of techniques useful for a patient whose auricle was amputated with severe contamination. We report two cases of auricular reconstruction using modified pocket method in traumatic auricular amputation with a review of literatures.
Amputation ; Ear Auricle ; Humans ; Lacerations ; Reconstructive Surgical Procedures

Vascular injury resulting from lower limb amputation leads to the redistribution of blood flow and changes in vascular terminal resistance, which can affect the cardiovascular system. However, there was no clear understanding of how different amputation levels affect the cardiovascular system in animal experiments. Therefore, this study established two animal models of above-knee amputation (AKA) and below-knee amputation (BKA) to explore the effects of different amputation levels on the cardiovascular system through blood and histopathological examinations. The results showed that amputation caused pathological changes in the cardiovascular system of animals, including endothelial injury, inflammation, and angiosclerosis. The degree of cardiovascular injury was higher in the AKA group than in the BKA group. This study sheds light on the internal mechanisms of amputation's impact on the cardiovascular system. Based on the amputation level of patients, the findings recommend more comprehensive and targeted monitoring after surgery and necessary interventions to prevent cardiovascular diseases.
Animals ; Animal Experimentation ; Cardiovascular System ; Cardiovascular Diseases ; Hypertension ; Amputation, Surgical

Management of extensive bone and soft tissue defects, which occur after severe trauma of lower extremities and always lead to an unacceptable amputation in some cases, continues to challenge reconstructive surgeons. When performing lower extremity amputation, preservation of the knee joint has been put into a higher priority. The benefit of below-knee amputation over above-knee ones concentrates on a more normal gait with less energy expenditure during ambulation when a functioning knee joint is present.
Accidents, Traffic ; Amputation Stumps ; Amputation, Traumatic ; surgery ; Foot Injuries ; surgery ; Humans ; Infant ; Leg Injuries ; surgery ; Male ; Surgical Flaps

Adult ; Amputation ; methods ; Female ; Humans ; Knee Joint ; Leg Injuries ; surgery ; Male ; Surgical Flaps

PURPOSE: Cardiac troponin I (cTnI) is a highly sensitive and specific marker for myocardial injury, and is used to predict the outcomes in patients with acute coronary syndromes. Cardiovascular complications are the leading cause of morbidity and mortality in patients who underwent vascular surgical procedures. The aim of the study was to evaluate the association between the postoperative cTnI levels and a perioperative myocardial injury (MI) within 6 months after the vascular surgical procedures. METHODS: Eighty patients who underwent vascular surgery including an arterial bypass, amputation and a thrombectomy were included in this study. The blood samples were analyzed for cTnI immediately after surgery and 1, 2, and 3 days after surgery. RESULTS: An elevated cTnI was defined as a serum concentrations > 0.4 ng/ml in any of 4 samples. Seven patients (8.7%) had postoperative cTnI levels of > 0.4 ng/ml, which was associated with a higher risk of a postoperative cardiac event (P< 0.001) and 6 month mortality (P< 0.001). However, only 2 out of the 75 patients (91.3%) who had postoperative cTnI levels of < 0.4 ng/ml developed postoperative MI. CONCLUSION: A serum cTnI level > or =0.4 ng/ml may indicate myocardial damage after vascular surgical procedures. Therefore, the routine postoperative measurement of cTnI might be a useful predictive value of the postoperative cardiac events after vascular surgical procedures.
Acute Coronary Syndrome ; Amputation ; Humans ; Mortality ; Thrombectomy ; Troponin I* ; Troponin* ; Vascular Surgical Procedures*