Yoshimoto Kenji, Okuma Yusuke, Nakamura Takashi, Mita Tomoki, Mitsumoto Atsuko, Yamasaki Nobuya, Tobimatsu Yoshiko, Akai Masami
1Department of Rehabilitation Medicine, Hospital for National Rehabilitation Center, Tokorozawa, Japan.
Prosthet Orthot Int. 2013 Dec;37(6):489-94. doi: 10.1177/0309364613481797. Epub 2013 Apr 4.
We report our experiences of prosthetic fitting in quadruple amputees. Two patients underwent quadruple amputation after suffering from disseminated intravascular coagulation in conjunction with pneumococcemia with purpura fulminans.
The first patient, a 52-year-old man, underwent bilateral transradial, left transtibial, and right transfemoral amputation, and the second patient, a 62-year-old man, underwent bilateral transradial and bilateral transfemoral amputation, both for symmetrical peripheral gangrene subsequent to septic shock.
The amputations were accompanied by skin damage due to ischemic tissue changes both on the stumps and on the nose and/or lips. The combination of the intensive prosthetic rehabilitation program and supportive medical care led to completely independent functioning, including driving a car, with the use of four prosthetic limbs and a wheelchair in both cases.
Early initiation of a multidisciplinary approach can properly address impairments and minimize future disability.
我们报告了我们在四肢截肢患者假肢装配方面的经验。两名患者在患有弥散性血管内凝血合并暴发性紫癜性肺炎球菌血症后接受了四肢截肢手术。
第一名患者为52岁男性，接受了双侧经桡骨截肢、左侧经胫骨截肢和右侧经股骨截肢；第二名患者为62岁男性，接受了双侧经桡骨截肢和双侧经股骨截肢，两人均因感染性休克后对称性周围坏疽而截肢。
截肢手术伴有残端以及鼻子和/或嘴唇因缺血性组织变化而导致的皮肤损伤。强化假肢康复计划与支持性医疗护理相结合，使两名患者在使用四条假肢和轮椅的情况下实现了完全独立的功能，包括驾驶汽车。
早期启动多学科方法可以妥善处理损伤并将未来的残疾降至最低。
