Rehabilitacja i protezowanie po amputacji czterech kończyn – opis przypadku
Journal Title: Rehabilitacja Medyczna - Year 2015, Vol 19, Issue 4
Abstract
Four-limb amputation is carried out rarely. In life-threatening conditions of the patient, the need for its implementation may result in the occurrence of septic shock evolving with severe sepsis, as well as other rarely occurring complications – purpura fulminans (PF). These extremely dangerous systemic reactions of the organism may develop as a result of bacterial infection: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae type b, Legionella pneumophila, meningococcas – Neisseria meningitidis. The average stay of patients after four-limb amputation at the Institut Robert Merle d’Aubigné is about six months. During this time, patients participate in complex rehabilitation therapy, ergotherapy, sport and recreational therapy, prosthetic fitting, thus the production and adaptation of upper – and lower-limb prosthetics, and they are also under the care of a psychologist and a social assistant. During the entire stay, they are subject to on-site supervision of medical specialists: angiologist, diabetologist, cardiologist, podologist, psychiatrist, rehabilitation specialists, and undergo necessary medical consultations conducted in cooperation with other hospitals and clinics. This case description illustrates the clinical condition of a 35-year-old man following a skull injury complicated by hemodynamic shock and acute thrombotic distal ischemia of four limbs, which were amputated as a result of these complications. The paper illustrates the steps of rehabilitation that were carried out, as well as ergotherapy and prosthesis, the purpose of which was recovering efficiency and independence of the patient as much as possible, and to efficiently teach him how to perform daily activities in preparation for independent living. The presented case description shows that even a patient with such a difficult clinical interview, after passage of the initial shock of the near death experience and four-limb amputation, may return to being fit and start to live independently again.
Authors and Affiliations
Aneta Pirowska, Thibaud Vincent, Julie Clotilde-Trotel, Caroline Voiry, Elise Joannot, Doan Vu Tri, Gérard Chiesa
Keywords
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