Dear Colleagues.
I’m in need of input from your experiences with claudication induced
pain in Transtibial amputation.
The patient is 59 yrs old, male, average length TT amputation 2 yrs
post, 5′ 10″, 174 lbs. Peripheral vascular disease, non-diabetic. He
had multiple grafts and stents to try and save the limb and
the final result was loss of anterior and posterior tibial arteries.
His limb is fed by secondary vessels. CT scan this month showed
occlusion in several areas including one stent. The limb is atrophied
to average volume. He can walk for about 900 steps before pain begins
and it escalates quickly to 7/10. He then has to rest for 15 minutes
or more in order to reduce the pain enough to continue walking.
Standing is similarly affected. AMPRO test is K4. He is very
physically fit otherwise.
My question is whether there is evidence that elevated vacuum fitting
can improve circulation enough to reduce pain caused by claudication.
I put his suction socket under vacuum for a short test and he felt some
improvement in comfort. I don’t consider a suction socket well fitting
enough to truly test the theory.
What have your experiences shown in similar cases?
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Lane Ferrin
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