Dhole Sandip, K Prafull, Daulatabad Vandana S, Gaikar Rohit R, More Sumedh
Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND.
Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND.
Cureus. 2025 Feb 4;17(2):e78527. doi: 10.7759/cureus.78527. eCollection 2025 Feb.
Multiple limb amputations are uncommon and may result from various causes, including trauma, metabolic disorders, severe burns, purpura fulminans, and drug use. Such amputations pose substantial physical, emotional, and social challenges, necessitating a comprehensive and multidisciplinary rehabilitation approach. This report discusses the rehabilitation of a 30-year-old male patient with multiple limb amputations, including a right transradial amputation, a left transhumeral amputation, and a left transfemoral amputation, following a railway accident. The patient was managed with a multidisciplinary strategy, incorporating stump-strengthening exercises, scar mobilization techniques, and transcutaneous electrical nerve stimulation (TENS) therapy for neuroma management, supplemented by the administration of 2% lignocaine. Prosthetic devices, including a right below-elbow cosmo-functional prosthesis, a left above-elbow cosmo-functional prosthesis with a hook as a terminal device, and a left above-knee prosthesis, were fitted. Gait training was provided to enhance mobility, independence, and reintegration into daily and occupational activities. A tailored rehabilitation program, combined with psychological counseling, addressed both physical recovery and emotional well-being. Functional progress was assessed using the Nottingham Extended Activities of Daily Living (ADL) Index, which showed a significant improvement from a score of 0 to 27 after two weeks of rehabilitation. This case underscores the importance of individualized, multidisciplinary care in achieving optimal functional outcomes and quality of life for patients with multiple limb amputations.
多肢体截肢并不常见，可能由多种原因引起，包括创伤、代谢紊乱、严重烧伤、暴发性紫癜和药物使用。此类截肢带来了巨大的身体、情感和社会挑战，需要采取全面的多学科康复方法。本报告讨论了一名30岁男性多肢体截肢患者的康复情况，该患者在铁路事故后进行了右桡骨远端截肢、左肱骨近端截肢和左股骨近端截肢。患者采用多学科策略进行管理，包括残肢强化训练、瘢痕松动技术以及用于神经瘤管理的经皮电刺激神经疗法（TENS），并辅以2%利多卡因给药。安装了假肢装置，包括右肘下美容功能假肢、左肘上带钩终端装置的美容功能假肢和左膝上假肢。提供步态训练以提高活动能力、独立性，并使其重新融入日常和职业活动。一个量身定制的康复计划，结合心理咨询，兼顾了身体恢复和情绪健康。使用诺丁汉扩展日常生活活动（ADL）指数评估功能进展，结果显示康复两周后，得分从0分显著提高到27分。该病例强调了个性化多学科护理对于多肢体截肢患者实现最佳功能结果和生活质量的重要性。
