Paraplegia and transtibial amputation: successful ambulation after dual disability: a retrospective case report

Spinal Cord Series and Cases, 2017 · DOI: 10.1038/scsandc.2016.39 · Published: February 2, 2017

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

This case report describes the rehabilitation of a 42-year-old policeman with complete paraplegia and a transtibial amputation. The patient was fitted with a customized prosthesis and orthosis, and after 12 weeks of rehabilitation, he was able to walk independently with bilateral elbow crutches. This case suggests that functional ambulation is possible for individuals with both paraplegia and transtibial amputation, even with a complete spinal cord injury.

Study Duration

12 weeks

Participants

A 42-year-old policeman

Evidence Level

Level 4, Case Report

Key Findings

1
A patient with motor complete T12 paraplegia and right transtibial amputation achieved independent ambulation with a customized prosthesis and KAFO after 12 weeks of rehabilitation.
2
The patient's Walking Index for Spinal Cord Injury (WISCI) score improved from 0/20 to 12/20 points during the rehabilitation period.
3
The patient returned to work as a policeman (on desk duties) due to his ability to walk with orthoses and aids.

Research Summary

This case report presents the successful rehabilitation of a patient with motor complete T12 paraplegia and a right transtibial amputation, who achieved independent ambulation with a customized prosthesis and KAFO. The patient's rehabilitation involved intensive gait training and the use of a customized patella tendon bearing (PTB) prosthesis with extended uprights and a standard KAFO on the left leg. The study concludes that functional ambulation should not be restricted for individuals with low thoracic spinal cord injury, even with concurrent transtibial amputation, and that walking with orthoses can improve community reintegration and employment opportunities.

Practical Implications

Rehabilitation Potential

Individuals with paraplegia and transtibial amputation may achieve functional ambulation with appropriate rehabilitation strategies.

Prosthetic Customization

Customized prostheses and orthoses are essential for successful ambulation in this population.

Community Reintegration

Ambulation can improve community reintegration and employment opportunities for individuals with paraplegia and transtibial amputation, particularly in areas with limited wheelchair accessibility.

Study Limitations

1
Single-subject case report limits generalizability.
2
Retrospective design may introduce bias.
3
Lack of a control group makes it difficult to attribute the outcome solely to the intervention.

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