ABSTRACT
Postoperative immobility can exacerbate the physical and psychologic effects of limb loss. This case report presents a 37-year-old mother of two children who required a transtibial amputation. She received an early ambulation device called the bent knee temporary prosthesis (BKTP), which aids in early postoperative ambulation. Several early ambulation devices have been utilized in the past but have not found widespread favor. Although there is a paucity of research on this topic, available data suggest patient tolerance and benefit of early ambulation. A customizable, temporary below knee prosthesis such as the BKTP is valuable to study the safety and efficacy of early postoperative ambulation for improving outcomes for transtibial amputees.
Subject(s)
Amputation, Surgical/methods , Amputation, Surgical/rehabilitation , Knee Prosthesis , Leg/surgery , Osteomyelitis/surgery , Adult , Female , Humans , Prosthesis Design , Prosthesis FittingABSTRACT
Thoracic aortic aneurysms can be found incidentally, however, patients can also present with acute dissection and or rupture that can be fatal. Symptoms that might indicate dissection include chest and back pain as well as lightheadedness. The diagnosis can be made with imaging studies such as computed tomography or magnetic resonance angiogram and sometimes transesophageal echocardiogram. Management is based on the aneurysmal size, location, extension, and the presence of complications. Although smaller localized and slow growing aneurysms can be monitored, larger and or complicated ones may warrant immediate repair. Less-common complications include compression over anatomic structures in the vicinity including vessels and the mediastinum. We report a unique case of a 71-year-old man who presented with a very large thoracic aortic aneurysm with dissection causing compression over the brachiocephalic veins and the mediastinum leading to facial and upper extremity swelling, dysphagia, and cough. This case represents a rare but significant complication of thoracic aortic aneurysm and emphasizes the challenges of its management.
