[oanp-l] ortho experts
Rick
Description
Collection
Title:
[oanp-l] ortho experts
Creator:
Rick
Date:
2/12/2014
Text:
Thoughts & opinions requested.
Scenario:
64 y/o, 5'10 250 lb female w/IDDM & long Hx of diabetic neuropathy resulting in insensate feet & hands. Hx of Charcot ankles/feet since I've known her/ 2006. Her mother had B/L BKAs d/t diabetic issues by the time she was 60. Died before she was 70. This pt's feet are rigid, malformed blocks on the end of her legs. A DPM has been seeing her over the years for LE issues & she has been in & out of CROW boots/neuropathic walkers. Of late she has been using her L-CROW boot & a R-solid ankle plastic AFO (fully lined) in a custom shoe. Due to occasional barefoot ambulation- during annual Florida vacations- she has Hx of Hallux & or 1st met head ulcerations. Some heal via long term use of CROW boot & others resulted in Hallux amputation on the L, a transmet' amputation on the R & NUMEROUS skin graft procedures.
Current situation is recent lower 1/3rd tibial Fx on the R d/t a fall. Her main source of treatment over the yrs has been a DPM w/ankle surgery specialty touted. DPM Rx'd & provided an air walking boot for the Fx. pt called today to report her tibia is callousing nicely, but when reviewing this follow up Xray, the DPM noticed a newer Fx on the fibula. pt reports DPM has decided to treat this Fx using an EXTERNAL FIXATOR!!! Am I just losing it, missing something or what???! An external fixator on a fragile diabetic w/the Hx breifly detailed above...really? I have highly recommended a 2nd opinion w/a real orthopedic surgeon, but she's hesitant.
Sorry to vent...but....they say WE have a financial interest in what WE do?!!!!
Rick, CPO
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Scenario:
64 y/o, 5'10 250 lb female w/IDDM & long Hx of diabetic neuropathy resulting in insensate feet & hands. Hx of Charcot ankles/feet since I've known her/ 2006. Her mother had B/L BKAs d/t diabetic issues by the time she was 60. Died before she was 70. This pt's feet are rigid, malformed blocks on the end of her legs. A DPM has been seeing her over the years for LE issues & she has been in & out of CROW boots/neuropathic walkers. Of late she has been using her L-CROW boot & a R-solid ankle plastic AFO (fully lined) in a custom shoe. Due to occasional barefoot ambulation- during annual Florida vacations- she has Hx of Hallux & or 1st met head ulcerations. Some heal via long term use of CROW boot & others resulted in Hallux amputation on the L, a transmet' amputation on the R & NUMEROUS skin graft procedures.
Current situation is recent lower 1/3rd tibial Fx on the R d/t a fall. Her main source of treatment over the yrs has been a DPM w/ankle surgery specialty touted. DPM Rx'd & provided an air walking boot for the Fx. pt called today to report her tibia is callousing nicely, but when reviewing this follow up Xray, the DPM noticed a newer Fx on the fibula. pt reports DPM has decided to treat this Fx using an EXTERNAL FIXATOR!!! Am I just losing it, missing something or what???! An external fixator on a fragile diabetic w/the Hx breifly detailed above...really? I have highly recommended a 2nd opinion w/a real orthopedic surgeon, but she's hesitant.
Sorry to vent...but....they say WE have a financial interest in what WE do?!!!!
Rick, CPO
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Rick, “[oanp-l] ortho experts,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/236102.
