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

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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

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