Mustafah Nadia Mohd, Bakar Noriani Abu, Yang Chung Tze
Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Discipline of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Rehabilitation Medicine, Hospital Melaka, Melaka, Malaysia.
Spinal Cord Ser Cases. 2016 Jan 7;2:15031. doi: 10.1038/scsandc.2015.31. eCollection 2016.
We describe a case of 55-years-old man with a known T11 AIS C since 1985. The muscle strength of his left leg is better than the right leg and he is an active community ambulator. He walks using his right knee ankle foot orthosis without a knee lock. However, on April 2012 he had undergone a left transtibial amputation secondary to infected diabetic foot ulcer. He only had his first contact with rehabilitation team 2 months after the amputation and started on gait retraining since. Given the fact that he is a K3 level as he used to climb Batu Caves which is known to have 272 steps and he plans to continue this activity for his religious purposes, we prescribed him with prosthesis - patella tendon bearing socket, pin and lock suspension, silicone liner and energy storing foot. In conclusion, a community ambulator in dual disabilities, that is, spinal cord injury and amputee is hardly encountered due to multiple confounding factors. However, the right prosthetic prescription in patient with good prognosticating factors to ambulate will determine successful rehabilitation.
我们描述了一例自1985年起就患有T11先天性特发性脊柱侧凸的55岁男性患者。他左腿的肌肉力量比右腿好，是一名活跃的社区行走者。他使用右膝踝足矫形器行走，没有膝关节锁定装置。然而，2012年4月，他因糖尿病足溃疡感染接受了左小腿截肢手术。截肢后2个月他才首次接触康复团队，并从那时开始进行步态再训练。鉴于他过去能够攀爬拥有272级台阶的黑风洞，且他计划为了宗教目的继续这项活动，所以他属于K3级，我们为他配备了假体——髌腱承重接受腔、针和锁式悬吊装置、硅胶内衬以及储能脚。总之，由于多种混杂因素，很难遇到同时患有脊髓损伤和截肢这两种残疾的社区行走者。然而，为有良好行走预后因素的患者开具正确的假肢处方将决定康复是否成功。
