RSD Patient
Derek Kozar
Description
Collection
Title:
RSD Patient
Creator:
Derek Kozar
Date:
11/9/2001
Text:
This is the first time I have dealt with a lower extremity RSD
case...looking for some advice.
Patient is 34 year old male, otherwise healthy, normal weight and
build. Sprained his ankle 18 months ago at work. Swelling persisted
and he was sent to an Orthopod who diagnosed RSD 3 months later. Has
tried everything....physio, nerve blocks etc., is on morphine for the
pain and is trying eastern medicine stuff now. He has pretty much
accepted the fact that he may not get better and amputation may be the
only option (he has discussed this with his Doctor already....it did not
start with me!)
He has never been prescribed any bracing or other devices to remedy the
pain until now (little late). He is in extreme pain from 4 inches
proximal to the malleoli distally. Around the malleoli he describes a
hot pain like someone was holding a torch to his skin. Over the
dorsum of his foot, any contact is painful and heavy. The dorsum of
the foot is swollen to the size of those mini footballs (I took
pictures, but not ready yet). The plantar surface he can accept 25% BW
for short periods of time with a cane, the rest of the time is in
cruthes.
What to do?
Options.....
1) PTB orthosis...I am wary of this due to pitting edema distal to the
knee (all throughout the weight bearing area actually), and the fact
that the pain seems to be migrating proximally.
2) Total contact AFO....don't think he would be able to tolerate
casting....
3) Modify an Air Cast so no contact M/L, with a custom footbed.
Money is not a concern here....Workers Compensation will do anything to
avoid amputation....
Any advice would be appreciated.
Thanks
Derek Kozar, M.Sc., C.O.(c)
case...looking for some advice.
Patient is 34 year old male, otherwise healthy, normal weight and
build. Sprained his ankle 18 months ago at work. Swelling persisted
and he was sent to an Orthopod who diagnosed RSD 3 months later. Has
tried everything....physio, nerve blocks etc., is on morphine for the
pain and is trying eastern medicine stuff now. He has pretty much
accepted the fact that he may not get better and amputation may be the
only option (he has discussed this with his Doctor already....it did not
start with me!)
He has never been prescribed any bracing or other devices to remedy the
pain until now (little late). He is in extreme pain from 4 inches
proximal to the malleoli distally. Around the malleoli he describes a
hot pain like someone was holding a torch to his skin. Over the
dorsum of his foot, any contact is painful and heavy. The dorsum of
the foot is swollen to the size of those mini footballs (I took
pictures, but not ready yet). The plantar surface he can accept 25% BW
for short periods of time with a cane, the rest of the time is in
cruthes.
What to do?
Options.....
1) PTB orthosis...I am wary of this due to pitting edema distal to the
knee (all throughout the weight bearing area actually), and the fact
that the pain seems to be migrating proximally.
2) Total contact AFO....don't think he would be able to tolerate
casting....
3) Modify an Air Cast so no contact M/L, with a custom footbed.
Money is not a concern here....Workers Compensation will do anything to
avoid amputation....
Any advice would be appreciated.
Thanks
Derek Kozar, M.Sc., C.O.(c)
Citation
Derek Kozar, “RSD Patient,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/217946.
