CASE REPORT


Rehabilitation and Prosthetic Design after Van Nes Rotationplasty of the Left Leg Due to Severe Burn Contractures in a Patient with Contralateral Amputated Right Femur: A Case Report



Minos Tyllianakis, Andreas Panagopoulos*, Konstantinos Fokas, Argyriadi Eleni, Panagiotis Megas
Orthopaedic Department, Patras University Hospital, Patras, Greece


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Creative Commons License
© 2019 Tyllianakis et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Orthopaedic Department, Patras University Hospital, Papanikolaou 1, 26504 Rio-Patras, Greece; Tel: +302613603883; Mob: +306944363624; E-mail: andpan21@ gmail.com


Abstract

Background:

Van Nes Rotationplasty (VNRP) is a biological reconstructive surgical method for pediatric sarcoma, complex trauma or severe lower limb deficiencies that often gets overlooked due to cosmetic reasons and psychological aspects. We report a unique case of knee stiffness and severe scarring from burns treated with this technique in a young patient who had also amputated contralateral femur.

Case Report:

A 15-year-old boy was trapped in a fire 10 years ago and sustained extensive contractures on his left knee due to severe burns and also an above knee amputation on his right thigh. For 10 years the boy had never received rehabilitation or worn any prosthesis and he managed to move bearing mainly on his palms. On admission to our hospital Van Nes rotationplasty was preferred among other treatment options as the most suitable solution for him and was successfully performed without complications.

The patient had severe stiffness on his right hip and decreased muscle power in the VNRP leg but after intensive physiotherapy he was able to stand upright and walk again using custom made bilateral prostheses and crutches.

Conclusion:

VNPR is a reasonable option in severe contractures and scarring of the knee joint.

Keywords: Van Nes Rotationplasty, Knee, Physiotherapy, Prostheses, Scar tissue, Amputation.