Journal of Physiotherapy & Physical Rehabilitation

Background

Poor wound healing following a major lower limb amputation can result in poor rehabilitation outcomes, which can be further worsened if the patient has recurrent falls and stump trauma during the wound healing stage. Direct trauma to the stump can result in bony fractures at the margins of the residual bones, and loose bony fragments may form inside the stump. These bony fragments can hinder the process of stump wound healing and interfere with prosthetic limb use and rehabilitation.

Case Description and Methods

We report this unusual case of 54 years old female patient who had a poor postoperative stump wound healing following a direct stump trauma due to a fall during the early postoperative recovery phase. She failed to respond to several weeks of conservative treatment.

Findings

A plain radiograph of the stump showed several body fragments migrated from a fracture at the distal tibial margin. A few weeks later, the patient noticed a sizeable body fragment spontaneously fell from the unhealed area of the stump. Shortly following this, her incisional wound showed signs of complete healing.

Outcomes and Conclusion

We think that this bony spur is the most likely culprit behind the patient's unusually prolonged wound healing. We discussed this case at the local MDT meeting in order to share the knowledge amongst the team and to raise vigilance about the need for early investigations in similar scenarios, particularly following direct trauma to the amputation residuum.

Background: Flexibility is a skill of great importance to prevent the occurrence of muscle damage, and it constantly needs to be improved so that its benefits extend throughout life. Individuals with a higher body mass index (BMI) have a lower level of flexibility than those with normal weight or underweight. Objective: To correlate the flexibility with BMI of eutrophic and overweight recreational runners. Methods: This is a cross-sectional study conducted with 35 Brazilian recreational runners (22 women and 13 men), aged 34.65 ± 9.47 years. The period of running training data was obtained from a specific questionnaire. The body mass and height were measured to calculate BMI. Flexibility was assessed by the sit and reach test using a Wells Bench. Results: Most participants were recreational runners for less than one year (68.6%, n = 24) and had a BMI classified as overweight (57.1%, n=20). There was no difference in the classification and value of flexibility and the period of running training between eutrophic and overweight subjects (p ≥ 0.05). Among overweight participants, an inversely correlation was found between BMI and flexibility (p = 0.047). Conclusion: Overweight recreational runners need to reduce their BMI to improve their flexibility.