Background: Pirogoff amputation is a calcaneal amputation invented by Nicolás Pirogoff that involves partial preservation of the calcaneus.

Case: A 59-year-old woman was diagnosed with left Lisfranc and Chopart joint fracture-dislocation 9 months after a fall. The patient underwent debridement together with Pirogoff amputation and surgery to place an Ilizarov external fixator. Five months later, the patient was transferred to a rehabilitation hospital. Because of inadequate bone fusion, for 3 months after the amputation the patient underwent gait training with a patellar tendon weight-bearing orthosis to avoid loading the amputated side. After fusion of the bone, the patient was able to walk using a Syme prosthesis and a cane. Three months after discharge from the rehabilitation hospital, the patient was diagnosed with hallux osteomyelitis of the other foot that was associated with the exacerbation of hallux valgus. The patient underwent hallux correction surgery. Three and a half months after the second hospital admission, the patient was again admitted to the rehabilitation hospital. At the end of the rehabilitation program, the patient was able to walk using a cane and a prosthesis.

Discussion: Appropriate orthotic treatment and care of the non-amputated limb are of great importance in patients who have undergone a partial foot amputation.

Background: Surgical treatment of femoral neck fractures is usually performed as an urgent procedure so that restoration of the ability to stand and walk can be achieved as quickly as possible. However, orthopedic surgeons need to be aware of undertreated or untreated diseases in their patients. Organ transplant recipients require immunosuppressive agents and steroids postoperatively. Hemodialysis patients also exhibit immunological deterioration and are included among immunocompromised patients. We report a case in which conservative treatment was chosen for a hepatic transplant recipient on hemodialysis who suffered a femoral neck fracture because signs of inflammation of unknown etiology were intermittently seen.

Case: The patient was a 70-year-old man who had undergone liver transplantation from a living donor as treatment for hepatocellular cancer and hepatic failure with cirrhosis. Dialysis for end-stage renal failure was initiated at approximately 1 year postoperatively. Cyclosporine was administered as an immunosuppressive agent. The patient subsequently fell off a bicycle and was unable to walk because of right hip pain. He was brought to our hospital by ambulance, and a right hip radiograph revealed a femoral neck fracture. His white blood cell count and C-reactive protein levels were intermittently elevated with unknown etiology. Conservative treatment was finally adopted, although a bipolar hip arthroplasty was planned. At 5 months after the injury, the patient was able to walk alone in a stable manner using a pair of crutches and was discharged.

Discussion: Conservative treatment for a femoral neck fracture, which generally requires surgery, may be acceptable in organ transplant recipients on hemodialysis.

Objectives : A pilot study was conducted primarily to examine the effect of rehabilitation using the Screw Block^® kit on the upper limb function of hemiplegic stroke patients.

Methods : In this pilot, single-center, quasi-randomized, controlled trial, 30 stroke patients were randomly allocated to either the experimental group or the control group. They received training with either Screw Block^® for 20 min in addition to conventional occupational therapy (20–40 min) or conventional occupational therapy, which included upper limb functional training for 40–60 min. In both groups, training was conducted 5 days a week for 3 weeks (15 sessions in total). Upper extremity function on the paralyzed side, which was the primary outcome, was evaluated using the Simple Test for Evaluating Hand Function (STEF) before and after the interventions.

Results : The study sample included 28 men and 2 women (mean age, 62.5 years). The experimental group showed a significant improvement in mean STEF score compared with the control group (T=2.252, P=0.032, Cohen’s d=0.82).

Conclusion : Occupational therapy using Screw Block^® was more effective than conventional occupational therapy alone in improving the upper limb function in stroke patients.

Objectives: The aim of this study was to investigate how baseline laboratory data and changes in physical function due to preoperative rehabilitation training in gastrointestinal cancer (GIC) patients can influence the frequency of postoperative complications (PCs).

Methods: We enrolled 45 patients who were scheduled for elective surgery for GIC (27 men and 18 women, mean age 63.6±9.5 years). All patients underwent a medical examination and received general instruction from a rehabilitation physician and exercise instruction from a physical therapist from 7 to 34 days before the surgery. PCs were graded using the Clavien-Dindo classification based on the medical records 1 month postoperatively. We measured the grip strength and the isometric knee extension torque and conducted the 6-min walk test (6MWT) at baseline and just before surgery. The surgical duration, blood loss, and blood transfusion data were collected. Baseline laboratory information, including C-reactive protein levels, serum albumin levels, platelet count, white blood cell count, and the estimated glomerular filtration rate, was recorded.

Results: The frequency of PCs was negatively correlated to the change in the 6MWT (β=−0.36) and positively correlated to the surgical duration (β=0.41). Baseline albumin was positively correlated to the change in the 6MWT distance (β=0.35). This model demonstrated an acceptable fit to the data (goodness of fit index=0.980, comparative fit index=1.000, root mean square error of approximation=0.000).

Conclusions: The improvement of gait ability achieved with preoperative rehabilitation training in patients undergoing elective GIC surgery led to decreased PCs.