Difficult case AK/BK

Gary M. Berke

Description

Title:

Difficult case AK/BK

Creator:

Gary M. Berke

Date:

8/27/1999

Text:

I am looking for advice on a complicated case. This is a 30 yo male
involved in a MVA and fire. He was burned and has subsequent skin grafts
over the lower 2/3 of his body. He suffered a Left trans-femoral amputation
that is completely covered in skin graft except of about 2 of tissue in his
groin. the scars continue up the lateral side of his leg to his axilla. He
has a slight flexion contracture on this side with adhered tissue over a
very bony distal end that continues to break down. He has little sensation
on the left side and an invaginated scar down the posterior aspect.

On the right he has a very short (13cm) Trans-Tibial amputation with scar
tissue up to his groin except on the distal lateral aspect of the limb.
There is a neuroma present on the posterior aspect of his limb just distal
to the popliteal and increasing hetrotropic ossification on the distal end.
He has an adhesion on the distal end that hasn't broken down but is pretty
angry.

He is currently in his first set of prostheses, after a revision of the
transtibial side, which subsequently healed by secondary intent following
infection. He is currently using a TEC liner on the transtibial side and a
conventional ishial containment socket on the trans-femoral side with a RTV
end pad and socks. He has increased his sock ply by over 5 ply over the
last week due to shrinkage of his limb.

Where I believe that we can engage in meaningful discussion is with those
that have experience in treatment or ideas related to patients with
significant skin graft and burns and adhesions, patients with hetrotropic
ossification that continues to change and grow as well as treatment of
patients with persistent neuroma. thanks in advance. gb

Gary M. Berke MS, CP
Assistant Professor, Orthopaedic Surgery
University of Oklahoma
<Email Address Redacted>

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Citation

Gary M. Berke, “Difficult case AK/BK,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/212475.