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Case Report  |   August 2020
Orthotics to Improve Pain in a Patient With Multiple Internal Fixations and Multilevel Thoracic Fusion
Author Notes
  • From the Veterans Affairs Medical Center in Hampton, Virginia (Dr Lipton); Dwight D. Eisenhower Army Medical Center in Fort Gordon, Georgia (Dr Kokoski); and Christopher Newport University in Newport News, Virginia (Ms Lipton).  
  • Dr Lipton is a professor of osteopathic manipulative medicine and physical medicine and rehabilitation. Dr Kokoski is the battalion surgeon for the 1-8 infantry. Ms Lipton is a Rokovich Scholar.  
  • Disclaimer: The views in this article are those of the authors and do not reflect the official policy or position of the Department of the Army, the Department of Defense, or the United States Government.  
  • Financial Disclosures: None reported.  
  • Support: None reported.  
  •  *Address correspondence to Jordan E. Kokoski, DO, CPT, Eisenhower Army Medical Center, 300 E Hospital Rd, Fort Gordon, GA 30905-5741. Email: jdnnkoko@gmail.com
     
Article Information
Emergency Medicine / Neuromusculoskeletal Disorders / Pain Management/Palliative Care
Case Report   |   August 2020
Orthotics to Improve Pain in a Patient With Multiple Internal Fixations and Multilevel Thoracic Fusion
The Journal of the American Osteopathic Association Published Online First on August 5, 2020. doi:https://doi.org/10.7556/jaoa.2020.105
The Journal of the American Osteopathic Association Published Online First on August 5, 2020. doi:https://doi.org/10.7556/jaoa.2020.105
Abstract

The authors present the case of a 24-year-old man who sustained multiple injuries during a hard landing following a parachute jump. These injuries included a right sacral fracture, bilateral femoral fractures, a separated pubic symphysis, and compression fractures of the fifth and sixth thoracic vertebrae. He was treated with a right sacroiliac joint fixation, pubic symphysis fixation, open reduction internal fixation of his bilateral femurs, and fusion of the third through seventh thoracic vertebrae. The patient experienced back pain, bilateral hip pain, and bilateral knee pain resistant to chiropractic and medical treatments. The patient presented 2 years after his aforementioned surgical procedures for treatment of persistent postoperative pain at the Physical Medicine and Rehabilitation service at the Veterans Affairs Medical Center in Hampton, Virginia. His treatment involved gait correction achieved using a left-sided heel lift and a transition to custom molded orthotics that incorporated the lift. This treatment leveled his sacral base and resulted in a simultaneous decrease in his self-reported pain scores.

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