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Final Program


Final Program

Musculoskeletal

1026 - Managing Amputations with Limited Resources in Mexico

Friday, February 20, 2026
5:00 PM - 6:30 PM AST
Case Diagnosis:  Transtibial amputation due to diabetic foot

Case Description:  A 65-year-old male presented to the rehabilitation building of a free clinic in Puerto Peñasco, Mexico. He had a history of uncontrolled diabetes complicated by a right diabetic foot infection requiring transtibial amputation performed by a local orthopedic surgeon. Due to socioeconomic limitations, the patient did not receive follow-up care, physical therapy, or prosthetic evaluation. Months later, he sought care at our free rehabilitation clinic, which operates once a month. At presentation, the patient was provided education on proper crutch use, contralateral foot surveillance with a mirror, strength and mobility exercises, and wound monitoring for infection. His crutches were adjusted to improve safety and independence.

Discussions:

 This case highlights the challenges of amputation care in resource-limited settings. Aggressive amputations are common in Puerto Peñasco, where access to specialty follow-up and prosthetics is limited despite a national system of “universal healthcare.” While the clinic maintains ties with a prosthetist who visits 1–2 times per year, poor coordination makes timely referrals difficult. The rehabilitation team relies heavily on education, donated mobility aids, and basic therapy to optimize outcomes.

In contrast, patients in the United States typically receive structured perioperative care, including early rehabilitation, prosthetic planning, and multidisciplinary follow-up. This disparity underscores how systemic limitations and cultural barriers alter the rehabilitation process abroad. For PM&R, it illustrates the need for adaptability and advocacy in global health contexts.

Conclusions:  This case demonstrates the challenges of amputation rehabilitation in low-resource settings, including limited prosthetic access and reduced therapy intensity. PM&R clinicians must adapt by prioritizing education and functional independence. Addressing these disparities is essential to improving outcomes and advancing global PM&R.