The media have called it "a degenerative leg ailment" and "a debilitating leg condition." Both "Klippel-Trenaunay syndrome" and "Klippel-Trenaunay-Weber syndrome" are used interchangeably by broadcasters and writers. It's been said that Martin "may lose his leg" or "need amputation."
The proper name for Casey Martin's condition is Klippel-Trenaunay-Weber syndrome (KTW), now called Parkes-Weber syndrome. Although debilitating and painful, many people who have it do well with little treatment. Surgery is only needed in severe cases.
How it starts
People are born with KTW. Researchers aren't sure why it happens, because it doesn't seem to be passed down genetically. Usually the first sign noticed is a large port wine stain. This is a problem with the tiny blood vessels (capillaries) under the skin, which causes the skin to turn dark red or even purple, be raised up, and there may be bumps on it that bleed easily. Most often the port wine stain is large and since KTW usually affects a leg (three times more likely than other parts), the birthmark covers, for example, from buttock and hip to toe on the affected side of the body.
How it progresses
KTW causes other blood vessel problems in the leg it affects. The blood vessels grow excessively and form tangled bunches (hemangiomas), which can range from small and not very noticeable to huge masses. There can be varicose veins and twisted vessels. Sometimes hemangiomas may grow inside the body, in the internal organs.
Another problem KTW causes is the overgrowth of the soft tissues and bones in the leg (hypertrophy). Sometimes this happens in the leg without the blood vessel problems. It is this overgrowth that makes it hard to use and move the leg. The toes may also be affected.
The result
The blood vessel problems and the overgrowth lead to bleeding, pain, skin infections (cellulitis), difficulty walking, and blood clots (which may cut off blood circulation in the leg, or travel to other parts of the body and cause damage). Each person with KTW is affected in his or her own way, and the problems experienced may be only mildly uncomfortable to severely disabling.
Treatment
There is no cure for KTW. Many people with KTW are helped by simple treatments such as elastic compression stockings, which reduce pain and swelling. Laser therapy can reduce or eliminate the port wine stain. Sometimes surgery is needed to remove a large hemangioma or to remove excess tissue from a leg that is badly overgrown. In rare instances, the affected leg may need to be amputated because of blood clots or severe overgrowth.
Casey Martin
On May 29, 2001, the U.S. Supreme Court ruled that Casey Martin may use a golf cart to ride in tournaments, stating that this will not give Martin any special advantage. "What it can do, on the other hand," wrote Justice John Paul Stevens for the majority, "is allow Martin the chance to qualify for and compete in the athletic events offered to those members of the public who have the skill and desire to enter."
It's clear from watching Martin limp across the golf course that his KTW is causing him significant pain and disability in his right leg. Although golfers and the media are assigning this legal case a greater significance, Martin is just happy to be able to play like anyone else. "At least I don't have to worry about the cart being taken away from me. It's mine for good now," he said in a published interview.
