Rehabilitation of a patient following hand replantation after near-complete distal forearm amputation

Abstract Study design Case report. Introduction Reports of comprehensive rehabilitation following hand replantation are limited. Purpose of the study To describe hand therapy of a patient following hand replantation. Methods Right hand dominant 55 year-old male assessed 9 days following left hand re...

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Bibliographic Details
Published in:Journal of hand therapy 2014-07, Vol.27 (3), p.217-224
Main Authors: Sturm, Sarah M., DPT, Oxley, Sally B., PT, CHT, OCS, Cert MDT, Van Zant, R. Scott, PhD, PT
Format: Article
Language:English
Subjects:
Amputation
Amputation, Traumatic - rehabilitation
Amputation, Traumatic - surgery
Cardiovascular disease
Episode of Care
Forearm Injuries - rehabilitation
Forearm Injuries - surgery
Humans
Light
Male
Middle Aged
Pain
Physical Medicine and Rehabilitation
Physical Therapy Modalities
Plastic surgery
Recovery of Function
Rehabilitation
Replantation - rehabilitation
Surgical outcomes
Therapy
Trauma
Treatment Outcome
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Summary:Abstract Study design Case report. Introduction Reports of comprehensive rehabilitation following hand replantation are limited. Purpose of the study To describe hand therapy of a patient following hand replantation. Methods Right hand dominant 55 year-old male assessed 9 days following left hand replantation to treat distal forearm amputation. Patient presented with dorsal blocking orthotic. Initial status: AROM digits and thumb 0–20° extension, 0–40° flexion; absent light touch sensation; 0–1/5 hand strength. Patient underwent 70 hand therapy sessions over 13 months focusing on A/PROM, therapeutic exercise, neuromuscular re-education, and modalities to address functional limitations. Results Hand therapy discharge status: AROM digits and thumb form composite fist, thumb opposition to digit 3, light touch sensation (monofilament) 4.03 (digits 2, 4) and 4.17 (digits 1, 3, 5); 3− to 4−/5 hand strength. Discussion Hand therapy allowed for near complete functional return of the hand following replantation. Conclusion Comprehensive Hand therapy aided restoration of adequate sensation and strength for functional use of the replanted hand. Level of evidence 4
ISSN:0894-1130
1545-004X
DOI:10.1016/j.jht.2014.02.004