This is a report of a nine-year-old boy was transferred to our department for an intensive amputee rehabilitation. He had crushing injury of both lower extrimities due to a motor vehicle accident with a resultant an above the knee and a below the knee amputations. On admission he presented with comatous mental state due to epidural hematoma as demonstrated brain CT. And then, he had taken emergency below the knee amputation of the both lower extremities and craniectomy with hematoma evacuation. Two months later from accident, orthopedic doctor decided second operation of his left above the knee amputation because of tissue necrosis on the stump. Four months later from injury, he was transferred to our department with poor skin condition and joint contracture. His right knee showed 30 degree flexion contracture with diffuse infected open wounds on thigh and severe tenderness on the stump. Left stump also was keloid skinned. With comprehensive rehabilitation program, his stump condition improved but right side was not still good for fit the conventional below the knee prosthesis. So we prescribed temporary modified prosthesis that is combination of the below the knee prosthesis and ischial weight bearing orthosis for the relief of the weight bearing on the poor conditioned stump and releasing the pressure stress on the open wounds of the thigh. After then, we could start prosthetic training program and he became an functional ambulator including up and down stair activities with the bilateral crutches after 70days prosthetic training program. |