Physical therapist SUPERHUMANS CENTER lviv, L'vivs'ka Oblast', Ukraine
Case Diagnosis: Triple limb amputation with a non-functional shoulder joint in the preserved upper limb is extremely rare and presents severe biomechanical, psychosocial, and prosthetic challenges. Evidence for physiotherapy management in such extreme cases is limited.
Case Description: A 44-year-old male veteran sustained right transfemoral, left transtibial, and left transhumeral amputations, plus clavicle and forearm fractures. The contralateral upper limb lacked shoulder function. On admission to Superhumans Center (Ukraine), he was wheelchair bound, with residual limb pain, phantom limb syndrome, reduced core stability, and threatened contractures. He had limited self-care independence and required help with transfers, mobility and advanced daily tasks; psychologically, he showed anxiety, low confidence, and social withdrawal.
Discussions: A physiotherapy-led program included pre-prosthetic care (contracture prevention, limb shaping, phantom pain, trunk and seated balance), staged fitting of bilateral lower-limb and one upper-limb prosthesis, gait re-education progressing from supported to community ambulation, and comprehensive support (psychological counselling, family education, vocational reintegration)
Conclusions: Even in severe war-related polytrauma, individualized physical therapy within a multidisciplinary framework can restore meaningful independence. This case adds valuable insight into optimal strategies for prosthetic integration, gait training, fall prevention, and social reintegration in extreme amputation scenarios.
