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A case report: Transhumeral amputee treatment with osseointegrated prosthesis and rehabilitation

      Highlights

      • -
        First case report with 7 year follow-up for osseointegrated rehabilitation with a proximal transhumeral amputation in Chile.
      • -
        Osseointegrated rehabilitation of amputee allows more tolerance in prosthesis use for daily routine in this case report.
      • -
        In 7 years, follow-up after discharge in a proximal transhumeral amputation registrated better functional outcomes in this case report.

      Abstract

      People with proximal transhumeral amputation usually choose prosthesis as an alternative to improve occupational performance, but frequently presenting difficulties in the distal control, poor elevation to reach some object, and tolerance to use in ADL and day time, added to frustration and high perception of disability. This report described the results in the first experience with one patient who suffered a work accident in Chile in a long-term following up 7 years after discharge, who take the choice for osteointegrated prosthesis training for amputation at the proximal transhumeral level and hybrid system (electrical elbow and body-power hook), the patient has previous experience with conventional body-power prosthesis and caps. For this, a standard rehabilitation protocol was applied, modifying it in relation to the Chilean experience in classical prosthetic training. The evaluation methodology consisted of daily time measurement, functional test of 400 points (adapted), range of motion, VAS, and DASH. The patient underwent these tests with conventional mechanical support prostheses with a common cap before the osseointegration surgery and then at the end of the protocol with the new osseointegrated prostheses.
      The results showed an increase of 39% in the overall functionality in ADL according to the 400 pts test, according to the DASH test a decrease in perception in disability related to Work of 32 pts and increased tolerance to daily prosthetic use from 3 to 12 hrs and the function of upper extremity reach, greater support and tolerance to use, together with a better control of the prosthesis is highlighted.

      Keywords

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      References

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      2. (v1.)
      3. Occupational therapy Practice Framework: Domain & process 3rd Edition the American Journal of occupational therapy S25 Copyright © 2014 by the American occupational therapy association

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      JHT Read for Credit

      Quiz: # 683

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
      • # 1.
        Common problems with a traditional prosthesis following proximal transhumeral amputation are
        • a.
          difficulty in distal control
        • b.
          restricted shoulder elevation
        • c.
          skin intolerance
        • d.
          all of the above
      • # 2.
        The design of the study was
        • a.
          RCTs
        • b.
          case series
        • c.
          case report
        • d.
          prospective cohort
      • # 3.
        The patient
        • a.
          had had previous experience with wearing a traditional prosthesis
        • b.
          was given an osteointegrated prosthesis as an initial prosthesis
        • c.
          was provided with both a traditional prosthesis and an osteointegrated prosthesis for comparison during his initial rehabilitation
        • d.
          resisted any type of prosthesis for 7 years after his amputation
      • # 4.
        The most worrisome concern following the surgical implant is
        • a.
          bone necrosis at the distal stump
        • b.
          skin and flap perfusion
        • c.
          painful neuroma formation
        • d.
          biological rejection of the implant
      • # 5.
        Scores on all the important outcome measures showed improvement with the osteointegrated prosthesis
        • a.
          not true
        • b.
          true
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.