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在农村地区为膝下截肢患者提供的跨学科护理。

Interdisciplinary Care Provided in a Rural Setting to Patient with Below-Knee Amputation.

作者信息

Torres Joshua A, Griffin Thomas, Rogenmoser William D

机构信息

Physical Medicine and Rehabilitation, Edward Via College of Osteopathic Medicine, Monroe, USA.

Orthotics & Prosthetics, Snell's Orthotics & Prosthetics, Alexandria, USA.

出版信息

Cureus. 2023 Feb 6;15(2):e34700. doi: 10.7759/cureus.34700. eCollection 2023 Feb.

Abstract

As a result of severe injury, limb amputation remains a pivotal procedure to preserve residual function of an injured extremity. Complications following amputation can impact successful rehabilitation. This case report aims to highlight the clinical importance of interdisciplinary care demonstrated by a 65-year-old Caucasian male below-knee amputee (BKA) who presented to an amputee clinic with complaints of right distal tibia pain. He reported that he was seen at a small rural clinic and was told he had "deterioration of his tibia". Physical exam revealed a well-healed below-knee amputation stump with tenderness to palpation of the right lateral distal residual fibula. Upon prosthetic modifications managed by our prosthetist, the patient's symptoms persisted. Further work up by Physical Medicine and Rehabilitation (PM&R) revealed a sharp edge to the distal fibula and the need for surgical revision by plastic surgery. Conditions resulting from the initial operation left this patient with factors that significantly impacted the process of restoring function to this BKA. Management of care for amputees commonly involves a variety of healthcare provider consisting of, but not limited to, primary care, physiatrists, prosthetists, plastic surgeons, and physical and occupational therapists. The aim of this case report is to illustrate how the fundamental collaboration rooted in interdisciplinary care is paramount to ensure that comprehensive care is delivered to this complex patient population that reside in rural areas.

摘要

由于严重损伤,肢体截肢仍然是保留受伤肢体残余功能的关键手术。截肢后的并发症会影响康复的成功。本病例报告旨在强调跨学科护理的临床重要性,该护理由一名65岁的白人男性膝下截肢者(BKA)展示,他因右胫骨远端疼痛前往截肢者诊所就诊。他报告说,他曾在一家农村小诊所就诊,被告知患有“胫骨恶化”。体格检查发现膝下截肢残端愈合良好,右侧远端残余腓骨触诊时有压痛。在我们的假肢师进行假肢调整后,患者的症状仍然存在。物理医学与康复科(PM&R)的进一步检查发现腓骨远端有尖锐边缘,需要整形外科进行手术翻修。初次手术导致的情况使该患者出现了一些因素,这些因素严重影响了该膝下截肢者恢复功能的进程。截肢者的护理管理通常涉及多种医疗保健提供者,包括但不限于初级保健医生、物理治疗师、假肢师、整形外科医生以及物理治疗师和职业治疗师。本病例报告的目的是说明基于跨学科护理的基本协作对于确保为居住在农村地区的这一复杂患者群体提供全面护理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab76/9995249/a086589bddfb/cureus-0015-00000034700-i01.jpg

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