Sturm Sarah M, Oxley Sally B, Van Zant R Scott
St. Mary's Medical Center, Huntington, WV, USA.
Huntington Physical Therapy Rehabilitation Specialists, Huntington, WV, USA.
J Hand Ther. 2014 Jul-Sep;27(3):217-23; quiz 224. doi: 10.1016/j.jht.2014.02.004. Epub 2014 Feb 24.
Case report.
Reports of comprehensive rehabilitation following hand replantation are limited.
To describe hand therapy of a patient following hand replantation.
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.
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.
Hand therapy allowed for near complete functional return of the hand following replantation.
Comprehensive Hand therapy aided restoration of adequate sensation and strength for functional use of the replanted hand.
病例报告。
手部再植术后综合康复的报告有限。
描述一名手部再植患者的手部治疗情况。
一名55岁右利手男性，在左手再植治疗前臂远端截肢术后9天接受评估。患者佩戴背侧阻挡支具。初始状态：手指和拇指主动活动度（AROM）伸展0 - 20°，屈曲0 - 40°；轻触觉缺失；手部力量0 - 1/5。患者在13个月内接受了70次手部治疗，重点是主动/被动活动度（A/PROM）、治疗性锻炼、神经肌肉再教育以及解决功能受限的方法。
手部治疗出院时状态：手指和拇指主动活动度可形成复合拳，拇指可与示指对掌，轻触觉（单丝）：示指、环指为4.03，拇指、中指和小指为4.17；手部力量3 - 4/5。
手部治疗使再植术后手部功能近乎完全恢复。
综合手部治疗有助于恢复再植手功能使用所需的足够感觉和力量。
4级。
