脳梗塞右片麻痺に閉塞性動脈硬化症による右下腿切断を合併した一症例

概要

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A 65-year-old male was admitted to our hospital for rehabilitation after a right below-knee amputation in 1993 due to arteriosclerosis obliterans diagnosed in 1990. In addition, he had a right hemiplegia due to cerebral infarction since 15 years ago, developed myocardial infarction 8 years ago and necrosis on his right toe 6 years ago. We prescribed an ischial weight-bearing orthosis so that heavy pressure of workload on the amputated leg could be avoided. Furthermore, the orthosis had to bedevised as light as possible due to consideration of his ischemic heart disease and hemiplegia. The orthosis enabled him to walk after training exercise for 2 months. However, he could walk only a short distance because of the intermittent claudication by the other leg. We then performed a blocking on a lumber sympathetic nerve ganglion with a view to promoting blood supply to the leg. And it helped increase of his walking distance. In conclusion, we report a case in whom the orthosis and the lumbar sympathetic nerve ganglion block were effective for improvement of walking ability.
1998-02-18