Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg

• Published in: Prosthetics and orthotics international Vol. 38; no. 2; p. 167
• Main Authors: Simmelink, Elisabeth K, Rommers, Gerardus M, Gardeniers, Jean W M, Zijlstra, Henk
• Format: Journal Article
• Language: English
• Published: England 01.04.2014
• Subjects: Adolescent; Amputees - rehabilitation; Artificial Limbs; Female; Follow-Up Studies; Humans; Leg - blood supply; Magnetic Resonance Imaging; Prosthesis Design; Prosthesis Fitting; Tibia - surgery; Treatment Outcome; Vascular Malformations - complications; Weight-Bearing; rehabilitation; vascular malformation; lower limb prosthesis; Lower limb amputation; activities of daily living
• ISSN: 1746-1553
• DOI: 10.1177/0309364613496110

The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a normal socket fitting process was not possible. Using a multidisciplinary approach, a prosthesis was designed to enable full weight bearing in a flexed knee position with ischial tuberosity support to prevent full weight bearing on the tibial part of the stump. After training and adjustments to the design, a definitive prosthesis with a free motion mechanical knee joint could be used. During the training with this prosthesis, no skin problems were observed, and at the end of the rehabilitation, the patient had a high level of activities of daily living and sports. The above prosthetic solution with an adjusted socket design proved to be successful in this case. Clinical relevance In a patient with severe congenital vascular malformation deformity leading to a transtibial amputation, fitting of a good prosthesis without full weight bearing of the stump proved to be successful.