Preventable Burn Injury in a Person With Paraparesis Leading to Amputation: A Case Report

Spinal cord injury (SCI) often results in prolonged recovery and complications, as seen in the case of a 35-year-old mason who sustained an SCI after a 10-foot fall in June 2021. Initially presenting with lower limb paresis and loss of bladder and bowel control, he underwent D12-L2 fixation with decompression and showed a gradual recovery of motor and sensory function above the knees. However, due to sensory loss and inadequate awareness regarding pressure injury prevention, he developed sacral pressure sores, which were healing with appropriate wound care and pressure offloading. During this period, he sustained a severe burn to his right lower limb from accidental contact with a hot bike exhaust, which went unnoticed due to impaired sensation. Despite conservative treatment, the burn injury progressed to neuropathic ulcer formation, Charcot arthropathy, and secondary infection with osteomyelitis, necessitating repeated pus aspirations. Over six months, the infection persisted despite multiple hospital visits and empiric antibiotic therapy. Given the chronicity, repeated aspirations, and ongoing treatment burden, he was offered the option of a below-knee amputation as a definitive treatment after a thorough discussion of risks, benefits, and alternatives. Following amputation, he is planned for prosthetic fitting and comprehensive rehabilitation. This case highlights the importance of timely intervention, awareness of pressure injuries, and proactive management of sensory deficits to prevent secondary complications such as infections and amputations. A multidisciplinary approach, patient education, and preventive strategies are essential to improving outcomes and quality of life in individuals with SCI.