Case of Congenital Amputation
A congenital limb deficiency present in a child is both physically and emotionally distressing, as it affects not just loss of function & sensation but also the body image due to functional disability.
Neha, 14 year old child also had been through this, as part of her Left Upper limb, was missing by birth from the below elbow level and the remaining part did not function properly. Role of parents lower socio-economic condition and lack of awareness was the reason for delay in Prosthetic devices.
DCCW team identified and made efforts to obtain a functional limb replacement device. Then Transradial Prosthesis was prescribed from Kiwani Dharmavira Artificial limb centre, replaced her forearm missing below the elbow and worked on Cable operated mechanism for limb . This will help her to gain confidence in initiating activities of daily living.
Learning to use a prosthesis takes hard work and practice. Multi-disciplinary professionals aimed at to rehabilitate her to the maximum level of independence, so the team of DCCW Physiotherapist & Occupational Therapist assessed and worked on her needs with regards to the activities of daily living, use of device by training movements used to control terminal device with voluntary opening and closing for grasp and release mechanism .
Strength training protocol for the residual limb was carried out with resistive aids along with operation of the device with body movements. Soon she became independent in donning and doffing of prosthesis. The Upper limbs function aimed to engage her in tasks like Manipulation, expression of feeling and exploration of environment.
Now she has started bilateral use of hands in day to day activities of life which gives her both, functional and emotional satisfaction. Initiates holding, lifting and release of the objects. With the prosthesis and its limitations, she has fixed wrist with no rotatory movements of forearms
She is in long term follow-up for the therapy and has to wear the limb for 5-6 hours in a day. The rehabilitation process was fraught with difficulties, both physical and emotional. Now she is living her life with the given resolve with motivation & perseverance given by the team.
May be in future, child may get a more advanced prosthetic limb which would take her to different level of functioning by overcoming present device limitations.