Too often I skip over case reports because I do not have a clinical background and I am seldom involved in unique clinical case presentations. Two recent articles however, have caught my attention.
Most lower-limb amputees experience some form of pain and prosthetists often spend inordinate amounts of time making socket adjustments to alleviate the problem. De Boer and colleagues (2017) present the case of a 60 year-old diabetic patient with residual limb pain after a transfemoral amputation. Her movement was restricted because of the pain and she was confined to a chair. Drug therapies were ineffective. After a number of investigations, a CT scan revealed occlusion of an Iliac artery stent. The authors remind clinicians of the importance of considering claudication as a cause of pain and recommend more research on diagnosis and treatment of peripheral arterial occlusive disease in people with residual limb pain after amputation.
Walking in high-heels has been the topic of a number of studies about the biomechanical changes in gait as a result of the footwear. Prosthetists are sometimes confronted with the problem of allowing for shoes with a moderate heel in lower limb prostheses for female clients. In a paper published recently in OnlineFirst, Esposito and her colleagues present the case of a young female traumatic transtibial amputee who wished to wear stiletto heels for a formal social occasion. The clinical team successfully fitted the patient with a pediatric running foot and demonstrated a good biomechanical outcome.
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Prosthetics and Orthotics International
Boer, R. G. d., Paping, M. A., Kap, B., & Geertzen, J. H. (2017). Residual limb claudication after vascular transfemoral amputation. Prosthetics and Orthotics International, 41(6), 601-604. doi:10.1177/0309364617706747
Esposito, E. R., Lipe, D. H., & RC!bago, C. A. Creative prosthetic foot selection enables successful ambulation in stiletto high heels. Prosthetics and Orthotics International, 0(0), 0309364617741937. doi:10.1177/0309364617741937