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Thursday, April 24, 2014
Amputation & prosthetics
My nephew was born with Spina Bifida. He`s had to go to Shriners his whole life & he`s had several surgeries. He gets around with a wheelchair or crutches. He is now 20 years old. He has no feeling in his feet. His "lack of feeling" is mostly in his legs, but it`s more-so, the farther down it gets, until it hits his feet, which he cannot feel at all. Except that he says he`s start getting feeling in places he used to never have feeling. For example, he says he can feel the inside of his calves, but not the outside. & he says he`s starting to feel his heel & down his foot a little ways. His grandfather & him have discussed it & have decided to go to an orthopedic surgeon. He would the chance to be able to walk. They are thinking of getting amputation done below the knee & having prosthetics put on. I would like more information on this. Can you tell me more, maybe give me links to follow. Information on this type of surgery or even videos about it, online? I love him like he`s my own & I`d like to educate myself more on this subject. He has appt set up, but I`m not sure when it is. Any info you can provide will be well appreciated. Thank you for your time!
It is certainly appropriate to thoroughly consider and research the pros and cons of such a major decision as elective amputation of both legs. He/his parents/you should discuss with an orthopedist - one who has experience performing amputation surgeries, perhaps as well as with a PM&R (Physical Medicine and Rehabilitation) physician - one who has experience working with individuals with spina bifida. They can help determine the likelihood of functional walking with a pair of below-knee prostheses if bilateral below-knee amputation surgeries were to be done.
In particular, depending on the strength of his hip and thigh muscles, it may not be realistic for him to expect to be able to walk with prostheses, without also having to rely on such hand-held aids as crutches or canes, particularly when walking over uneven, banked, or inclined surfaces. If not already tried, bracing - particularly to correct foot drop and provide ankle stability - should be done first, prior to more seriously considering an irreversible intervention such as amputation.
For further information, including some online videos and FAQ's among a wealth of other information for amputees, consider also using this link to the Amputee Coalition of America's National Limb Loss Information Center (NLLIC) through which you may also e-mail a question, as well as contact that organization by phone.
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University