696 - Rehabilitation Challenges and Surgical Considerations Following Biceps Tendon Rupture in a Patient with Preexisting Right Shoulder Disarticulation and Transtibial Amputation with Osseointegration: A Case Report

Case Diagnosis: A 59-year-old male with a right shoulder disarticulation and right transfemoral amputation with osseointegration, secondary to a work injury, presented with a rupture of the left long head of the biceps tendon. This rupture, in his only functional upper limb, significantly impaired his ability to perform activities of daily living (ADLs). Imaging later revealed a concurrent tear of the left subscapularis tendon.

Case Description: In 2012, the patient sustained injuries resulting in right shoulder disarticulation and right transfemoral amputation. Despite a prosthesis, his right arm was non-functional. In 2023, he presented with left arm pain, and imaging confirmed a rupture of the left biceps tendon. This severely limited his ability to complete ADLs. Due to delays in surgical evaluation, he was admitted to acute inpatient rehabilitation, where he received adaptive equipment training and compensatory strategies. Despite his complex medical history, he made functional gains. Two months post-injury, he opted for surgical repair of both the biceps and subscapularis tendons.

Discussions: Amputees relying on a single limb face an increased risk of overuse injuries. This patient’s biceps tendon rupture compromised his independence, and the subscapularis tear underscored the cumulative strain on his remaining limb. Early identification and management are essential to prevent long-term disability in amputees. This case highlights the need for timely surgery and a multidisciplinary rehabilitation approach to optimize function and prevent complications.

Conclusions: This case underscores the challenges of rehabilitation for upper extremity amputees with overuse injuries. Timely surgical intervention and focused rehabilitation significantly improve functional outcomes, allowing patients to regain independence. Ongoing research is essential to understand and prevent overuse injuries in amputees, ensuring long-term function and quality of life.