CASE STUDY HARMONY PROSTHETIC SYSTEM Presented by Ellen Chu at NSW PAR meeting 10 th February 2006 1
Mr. G l 65 years old l Admitted to Mt Wilga Private Hospital on 31/05/05 following L trans-tibial amputation on 24/05/05. No post-op complications. l PMH: L&R unicompartmental knee replacements, NIDDM, OA shoulders, HT 2
HPI l. L fem bypass April 04, graft blocked twice in Jun 04 and Nov 04, unblocked by angioplasty. l Jan 05, graft blocked again and underwent fem-pop bypass. Graft blocked in April and May 05. l L Trans-tibial amputation 24/05/05 l R fem-pop bypass in Nov 03 ~30% flow 3
SHx l Lives with wife in a level house with no steps. l Previously independent with all ADL’s. l Preoperatively could mobilise up to 50 m before having to rest, due to pain. l Active, vice-president of a local soccer club. 4
On admission l Independent with bed mobility and transfer l Independent with hopping using a FASF ~25 m l Normal ROM except L knee -10° extension from previous surgery 5
Physiotherapy management l Mobility training l Strengthening exercises l Prone lying l CV fitness l Swelling management commenced on 14/06/05 (stump bandages and shrinkers) 6
l Casting on 05/07/05 for PTB prosthesis. l Prosthetic training commenced on 07/07/05 and he was progressed to walking with a walking stick on 11/07/05. l Discharged to home on 23/07/05. 7
Issues with PTB l Swelling control l Pain from the strap l Solution? ? 8
HARMONY System l Casting on 19/09/05 l No changes to actual gait pattern l No pain from the strap l No need to wear or adjust number of socks l More comfortable walking 9
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