Easton, et al Reference Easton, J. This prosthesis was essentially open over the abdomen to allow access to the colostomy and ileal bladder collection devices. They demonstrated that a patient could be suspended in a prosthesis in an upright position with enough stability to allow wheelchair ambulation.
Large openings were made in the plastic laminated socket to provide ventilation, reduce weight, and permit changing of ileal bladder and colostomy bags. A foam rubber lining one-half inch thick was used in the plastic socket to help distribute weight and avoid pressure necrosis.
One patient was fitted with a total lower body prosthesis that enabled him to ambulate with a swing-through gait using Lofstrand crutches. He later progressed to stairs and curbs. This patient subsequently qualified himself to drive an automobile wtih hand controls.
In making prostheses for our two patients, no attempt was made to copy the prostheses made at Minnesota or New York University, other than to be aware of the general concepts they developed. The following criteria have been established in our laboratory for paracorporectomy prostheses:. Fabrication of the prosthesis is accomplished by obtaining a plaster of Paris impression of the patient's trunk.
A stockinette tube is sewn closed on one end, pulled onto the trunk and held in place under tension by use of elastic straps over the patient's shoulders.
Patients can elevate the distal portion of the trunk while in the supine position. This allows adequate work area for applying the plaster of Paris bandages.
Elastic plaster of Paris bandages are used to wrap the proximal portion of the trunk. The wrap begins at the level of the fourth intercostal space. It is continued distally in a figure of eight pattern. Considerable tension is applied to form the bandages well under the tenth costal cartilage as far posterior as possible Fig.
Therefore, non-elastic plaster of Paris splints are applied distally to support the soft tissue. This prevents the complications of abdominal compression in the finished prosthesis, i.
The negative impression is filled with plaster of Paris and a mandrel provided for holding. The plaster of Paris positive is modified by building up with additional plaster at the end of the stump and paravertebrally to provide pressure relief at the distal end of the vertebral column and along the spines. It was the first time a hemicorporectomy had been attempted at Albany Med in recent memory.
Doctors did not bill for their services, which amounted to a multimillion-dollar donation on behalf of Reed, a Medicaid patient. He and the other surgeons practiced on a cadaver first.
There was a risk that Reed would bleed out and die on the operating table. As they sliced and sawed through fat, muscle, veins and bone, she required 26 units of blood to replace what was lost. At one point, her blood pressure dropped dangerously low. Reed has beaten the odds at every turn. She survived an abusive, backwoods Kentucky childhood. She endured the pain of chronic pressure sores and numerous surgeries as a paraplegic prior to the hemicorporectomy.
She bolted a rocky marriage and raised three children as a single mother. She ran a diner in Kentucky and attended night classes at a community college in Texas.
She worries about whether people actually love her or just feel sorry for her because of the amputation. Reed and her son John share an apartment with her partner, Terry Lincoln , 54, a computer programmer who left the workforce to help take care of her after surgery.
They share a cluttered two-bedroom, ground-floor unit off Main Street. The van promises freedom, but Reed is frequently in too much discomfort to go out. Mostly, she's stuck in a dark, dreary living space. Often, she's in too much pain to get out of bed. Copyright Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. Report a typo. Sign up for the Headlines Newsletter and receive up to date information.
Kevin Morrill, co-director of the Spine Center and assistant professor of neurological surgery; Dr. Joshua Lemmon, clinical assistant professor of plastic surgery; and Dr. Jamil Ahmad, chief resident in plastic surgery. Carlton Barnett, Jr. Note: Content may be edited for style and length. Science News. ScienceDaily, 19 November UT Southwestern Medical Center.
Last-resort lower-body amputation effective in extreme cases of bone infection, year review shows. Retrieved November 9, from www. Treating pelvic floor muscle spasm with botulinum toxin may
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