Sousa Rui, Diniz João, Bernardo Inês, Sousa Marlene, Vaz Mário
Physical Medicine and Rehabilitation, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, PRT.
Rheumatology, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, PRT.
Cureus. 2024 Oct 24;16(10):e72280. doi: 10.7759/cureus.72280. eCollection 2024 Oct.
Systemic sclerosis (SSc) is a complex connective tissue disease involving microvasculopathy, immune dysregulation, and extensive organ fibrosis. It affects various systems including the skin, lungs, heart, and gastrointestinal tract. Management is challenging due to the disease's heterogeneity and often requires more than just pharmacological treatment. Severe cases may necessitate amputation due to complications like tissue necrosis. This case report discusses the treatment of a 60-year-old man with cutaneous diffuse SSc who required multiple upper limb amputations due to progressive gangrene. Despite initial pharmacological and vascular interventions, the patient's condition led to metacarpophalangeal and transradial amputations. A multidisciplinary approach was crucial in determining the level of amputation and managing post-surgical rehabilitation. Following the transradial amputation, the patient participated in a comprehensive rehabilitation program to optimize functional recovery and prepare for prosthesis fitting. The case highlights the need for a multidisciplinary strategy in managing severe SSc complications and underscores the importance of tailored rehabilitation in improving functional outcomes and quality of life for amputees.
系统性硬化症（SSc）是一种复杂的结缔组织疾病，涉及微血管病变、免疫失调和广泛的器官纤维化。它会影响包括皮肤、肺、心脏和胃肠道在内的多个系统。由于该疾病的异质性，其管理具有挑战性，通常不仅需要药物治疗。严重病例可能因组织坏死等并发症而需要截肢。本病例报告讨论了一名60岁皮肤弥漫性SSc男性患者的治疗情况，该患者因进行性坏疽而需要多次上肢截肢。尽管最初进行了药物和血管干预，但患者的病情仍导致了掌指关节和经桡骨截肢。多学科方法对于确定截肢水平和管理术后康复至关重要。经桡骨截肢后，患者参加了全面的康复计划，以优化功能恢复并为假肢适配做准备。该病例强调了在管理严重SSc并发症时采用多学科策略的必要性，并强调了量身定制的康复对于改善截肢者功能结局和生活质量的重要性。
