Title : Rehabilitation management of a pediatric patient with mixed bone and soft tissue arteriovenous malformation of the lower extremity: A case report
Abstract:
Arteriovenous malformations (AVMs) are aggressive vascular anomalies that often result in significant morbidity. When present in the lower extremity, it can present with disabling consequences such as pain, hemorrhage, ulceration, dermatologic or osseous changes and clinical manifestations such as leg length discrepancy and pathologic fractures. Embolization therapy is the standard of care of AVMs while extensive lesions often require surgical interventions, including amputation for severe cases.
This is a case of a 16-year-old female seen at a tertiary hospital diagnosed with congenital soft tissue arteriovenous malformation with intra-articular and intra-osseous involvement of the lower extremity presenting with pain, skin discoloration, swelling and mass on the left lower extremity. Because of the extent of disability and severity of the lesion, the patient and the family were already appraised for above knee amputation. However, due to religious reasons, this was not feasible. The patient was then referred for rehabilitation to maximize conservative management and facilitate return of function. At the end of the patient’s inpatient rehabilitation and after follow-up during teleconsultation, the patient was able to go back to her usual ADLs, recreational activities and with noted improvement in gait pattern during ambulation.
This case report highlights the role of rehabilitation in the disabling consequences of a congenital lower extremity arteriovenous malformation to facilitate return of function.
