Hello colleagues,
I have a TT amputee client who by my best estimation suffers from what can best be described as some sort of anterior compartment syndrome. He dons his prosthesis and walks in perfect comfort for about 6-7 minutes before experiencing extreme ‘charlie-horse’ discomfort in the tibialis anterior area. This is relieved by sitting down and unloading the prosthesis, or even quicker, by doffing the leg completely. Within a few minutes he is good to go again. Despite being an amputee now for almost 2 years and being of rather slight build, he still has a fairly prominent tibialis anterior region, without the interosseous concavity we usually see with atrophy on a mature limb. He can visibly contract this muscle as evidenced by it bulging out. He has had every scan of his anatomy and bloodwork available and the physiatrist and myself, are puzzled. We have tried sockets with TPE liners, Pelite with socks, unloading thigh corset, flexible wall with cutout in the affected region and nothing has brought him past the 7 minute mark in terms of tolerance. Has anyone had experience with using a localized botox injection to paralyze the affected muscle group in situation such as this? Yes, we have considered the possibility of needing a myodesis surgery but he has already had several surgeries and is not keen on another.
Regards,
Markus Säufferer, B.Sc.(Kin), C.P.(c)
1145 Dufferin Cres.
Nanaimo, BC
250.591.1816
