Moita Gonçalves Eugénio, Alves Belmiro, Antunes Francisco, Vítor Gonçalves José, Aleixo Catarina, Vilaverde Daniel, Maçães Filipe, Correia Rodrigo, Andrade Inês, Ferreira Andreia
Physical Medicine and Rehabilitation, Vila Nova de Gaia/Espinho Hospital Center, Porto, PRT.
Research, Faculty of Medicine, University of Porto, Porto, PRT.
Cureus. 2023 Jul 4;15(7):e41348. doi: 10.7759/cureus.41348. eCollection 2023 Jul.
The demand for physical medicine and rehabilitation services has risen significantly. Immediate rehabilitation is not always readily available which may compromise patients' functional recovery. Here, we describe a rare subtalar dislocation case and how an unsupervised home-based rehabilitation program allowed functional recovery. A 49-year-old male presented to the emergency department with an injury to the right ankle which resulted from a 3-meter height fall with his foot in plantar flexion and inversion. Clinical and imaging findings confirmed a diagnosis of a rare case of subtalar dislocation. The post-injury AOFAS Ankle-Hindfoot Scale score was 24/100 points. After six weeks of immobilization, a patient-tailored home-based rehabilitation program was prescribed. Adherence to our home-based rehabilitation program was critical to allow a range-of-motion improvement and functional recovery. Delaying rehabilitation may lead to long-term functional impairments. Thus, acknowledging the post-acute period as critical to initiate rehabilitation is mandatory. When outpatient rehabilitation settings are not readily available due to high demand, comprehensive patient education, and home-based rehabilitation programs may constitute effective alternative interventions. We demonstrate the significant improvement obtained with an early patient-tailored home-based rehabilitation program in range-of-motion and functional outcomes in a case of medial subtalar dislocation.
对物理医学与康复服务的需求显著上升。即时康复并非总能轻易实现,这可能会影响患者的功能恢复。在此,我们描述一例罕见的距下关节脱位病例,以及一个无人监督的居家康复计划如何实现功能恢复。一名49岁男性因从3米高处坠落致右脚受伤,当时足部处于跖屈内翻位,被送往急诊科。临床和影像学检查结果证实诊断为罕见的距下关节脱位病例。伤后美国足与踝关节协会(AOFAS)踝 - 后足评分是24/100分。固定六周后,制定了一个针对患者的居家康复计划。坚持我们的居家康复计划对于改善活动范围和功能恢复至关重要。延迟康复可能导致长期功能障碍。因此,必须认识到急性期后是开始康复的关键时期。当由于需求高而无法立即获得门诊康复服务时,全面的患者教育和居家康复计划可能构成有效的替代干预措施。我们展示了在一例内侧距下关节脱位病例中,早期针对患者的居家康复计划在活动范围和功能结局方面取得的显著改善。