Quadruple Amputations in Professional Electrical Burns: A multidisciplinary Approach on Early Prosthetics and Patient Motivation

Abstract

Background: High-voltage electrical burns are a relatively uncommon but severe form of burn injury, frequently occurring in occupational settings. These injuries often cause extensive deep tissue destruction and may require repeated surgical debridement and major limb amputations. Survivors frequently experience profound functional impairment and psychological distress, making early multidisciplinary management paramount. Case Presentation: We report the case of a 32-year-old male electrician who sustained a work-related high-voltage electrical injury. The electrical current entered through both upper limbs and exited through both lower limbs, resulting in extensive necrosis of all four extremities. Initial management included repeated surgical debridements. Due to the extent of irreversible tissue destruction, definitive surgical treatment required bilateral scapulohumeral disarticulation and bilateral transtibial amputations. The patient was admitted to the intensive care unit for four days for hemodynamic stabilization and monitoring of systemic complications. Early psychological support was initiated to facilitate emotional adaptation and encourage active participation in the rehabilitation process. After satisfactory stump healing, the patient was transferred to a specialized rehabilitation unit where a structured rehabilitation program was implemented, including progressive prosthetic fitting. Lower-limb prostheses were fitted first to restore standing and gait, followed by upper-limb prostheses to improve functional autonomy. Conclusion: This case illustrates the potentially devastating consequences of high-voltage electrical injuries. We aim to demonstrate that meaningful functional recovery is possible through early multidisciplinary care. Early psychological support, structured rehabilitation, modern prosthetic fitting, and strong patient motivation are critical determinants of successful functional recovery and long-term social reintegration.