Friday, December 2, 2022

Treatment for Pt. with burn scaring

Theo Forosty

Hello List,

I was hoping to get some advice or suggestions regarding a patient
that was recently seen in clinic.

Pt. is an active 28 y.o. with a RT Transtibial amputation secondary to
an explosion 4 years ago. He is in need of a new socket after
developing a chronic ulcer on the distal aspect of his residual limb.
He is currently using a TSB socket with a gel locking liner w/ a
shuttle lock and a multi-axial foot.

He has an average length RL. Good strength with Hip Flexors and
Extensors 5/5 and Knee Flexors and Extensors 5/5.
He has scaring from a burn covering 60% TBSA which includes his entire
residual limb.

The patient also has upper limb involvement. He is missing digits B/L
and lacks full ROM in phalanges due to scarring. However, he is able
to donn a gel locking liner independently with the use of a custom
stand provided by our facility.

Pt has had a history of missing appointments and other compliancy issues.

For his next prosthesis we would like to continue use of a TSB socket
with a multi-axial foot and provide him with custom urethane liners.
Any suggestions or feedback would be appreciated. Thanks.

Theo Forosty CO, Prosthetic Resident

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