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Multi-trauma Case: Bilateral LE Orthotic Treatment
Transcript of Multi-trauma Case: Bilateral LE Orthotic Treatment
Heather Wilsey, PT, DPT Multi-trauma Case:
Bilateral LE Orthotic Treatment Left LE Right LE The Rest of the Story... Last Follow-up GOALS:
Reduce midfoot and toe flexion contractures
Accommodate foot/ankle for weight bearing GOALS:
Accommodate fixed contracture
Allow weight bearing
Maintain skin integrity Patient
KA 33 y/o male
1 child 2 y/o
Employed fulltime Skull/facial fx
Right LE: femur, fib head, ankle fx
Left LE: Tib/fib fx, 1st toe fx
Left UE: humerus fx
TBI MVA Nov 2010
Car vs. Tree
4 hr extrication
Multi-trauma History Jan 2011 May April Discharged to Home:
home health PT, OT, SLP Outpt PT
Eval O&P Consult Wheelchair only/NWB Left LE Compound tib/fib fx, external fixator
Flexible midfoot contracture, 40deg Right LE Fixed PF contracture, 40 deg
Right knee HO --> flexion limited to 15deg Orthosis Recommendation Thermoplastic articulated AFO
Step-lock OTS wrist joint at midfoot, lateral
Aliplast lining, 3/16"
Crepe heel build-up Fitting of "Transformer Boot"
July 14, 2011 Achieved Left LE weight bearing
Fully corrected midfoot contracture in 3 weeks
No ankle or midfoot surgical fusion was required Orthosis Recommendation Total contact AFO
Aliplast lining, 3/16"
Crepe sole build-up Fitting of "KISS Boot"
August 4, 2011 Accommodated Right LE deformity
Allowed weight bearing and ambulation Left AFO "Transformed" Sept/Oct 2011 Dec 18 Nov 18 September 2012:
Walking with a rolling walker
Able to walk with a cane
Still limited by hip weakness, right knee flexion limitation PT request: Can we help him stand? Thank You and