Case Diagnosis: Hemipelvectomy due to traumatic injury is frequently associated with multiple organs damage. The inability to sit, as result of asymmetrical pelvic shape reslts in unbalance, pressure ulcers, trunk misalignment and mobility reduction. We investigated different pad systems to afford a stable and functional position in wheelchair, considering the correct alignment of trunk-pelvis and the pressure distribution.
Case Description: An 18 years-old man underwent a right external hemipelvectomy after a motorcycle accident. Skin grafting at the amputation site and colostomy were necessary. The severity of clinical conditions constrained the patient to a prolonged bed rest. After three months, it was possible to sit him on a tilted wheelchair and, one month later, on a standard one. We used an air cushion to relieve completely the right hemipelvis and a backrest to improve the trunk stability. Later, we chose a modular customized cushion with polymer foams.
Regarding the body segments we used ISO16840-1. On bed, with and without cushion (air and modular) on wheelchair. On frontal plane, the modular cushion reached a precise alignment of scapulas and a greater reduction of kyphosis, on sagittal plane.
For the pressure analysis (ISO/TR 16480-9) the pick pressure was lower if compared with the air device, in static and in dynamic positions. The contact area, the best model for studying the weight distribution, was higher with both the cushions, meaning the better result, but the modular cushion revealed lower pressure picks in any condition.
DAVIDE DALLA COSTA– MEDICAL DOCTOR, ASST GRANDE OSPEDALE METROPOLITANO NIGUARDA
LAURA MARIANI– Occupational Therapist, ASST GRANDE OSPEDALE METROPOLITANO NIGUARDA
FEDERICO GIARDA– MD, ASST GRANDE OSPEDALE METROPOLITANO NIGUARDA
ROSARIA CAFORIO– MIss, Promedicare
ROSA ROGLIANI– Dr., ASST GRANDE OSPEDALE METROPOLITANO NIGUARDA
LUCIANA SCIUME'– Dr., ASST GRANDE OSPEDALE METROPOLITANO NIGUARDA
GIOVANNA BERETTA– Dr., ASST GRANDE OSPEDALE METROPOLITANO NIGUARDA