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Clinical Medicine: Case Reports

Synopsis: An open access, peer reviewed electronic journal that covers case reports in all areas of clinical medicine.


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Clinical Medicine: Case Reports is an international, open access, peer reviewed journal which considers case reports in all areas of clinical medicine which advance general medical knowledge.

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Submissions, excluding editorials, letters to the editor and dedications, will be peer reviewed by two reviewers.  Reviewers are required to provide fair, balanced and constructive reports.  

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ISSN: 1178-6450


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Rehabilitation following Surgery for Reconstruction of a Foot Defect

Authors: Susan Faber West, Peter E. Pidcoe
Publication Date: 15 Apr 2008
Clinical Medicine: Case Reports 2008:1 3-11

Susan Faber West1 and Peter E. Pidcoe2

1Department of Physical Therapy Outpatient Team, Medical College of Virginia Hospitals, Richmond, Virginia, U.S.A. 2Department of Physical Therapy, Virginia Commonwealth University—Medical College of Virginia, Richmond, VA 23298.

Abstract

Background:  This report illustrates the use of pressure for scar management to aid in foot re-shaping following a surgical intervention to repair an arterio-venous (AV) malformation.

Methods:  This report describes the rehabilitation of a 13-year-old girl after surgical reconstruction of a defect in her left foot following the removal of an AV malformation. Early surgical attempts to repair the problem resulted in complications that required the amputation of toes 2, 3, and 4, and the use of a split thickness skin graft to cover the plantar surface of the medial longitudinal arch on the left foot. Following surgery, the patient had an antalgic gait pattern with decreased weight bearing on the left. The graft obliterated the left medial longitudinal arch and the patient would only weight bear on the heel. The patient had decreased metatarsal joint mobility on the affected side and no movement in the remaining toes. Left talocrural joint active range-of-motion (AROM) was within normal limits and gross ankle muscle force production was assessed to have a grade of 3/5.

Results:  Treatment included reshaping the left foot using a pressure garment and orthotic, followed by interventions to address range-of-motion and muscle force production deficiencies. All treatment objectives were achieved and all patient goals were achieved.

Conclusions:  Pressure was effective in re-shaping the foot to promote normal gait mechanics.



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