Effectiveness of KIASTM in Post-surgical Wrist and Hand Rehabilitation following Spaghetti Wrist Injury- A Single Case Report

Abstract

Background and Objectives: The deep laceration of the distal volar forearm is referred as “Spaghetti wrist”. As the structures at the wrist are tightly packed and thinly covered, lacerations of tendons, nerves, and arteries are likely. The injury of exposed tendons on a red background resemble pasta noodles in a bed of tomato sauce. Flexor tendon injuries along with median nerve injuries are very common following accidental cut injuries at wrist. Most commonly injured tendons include FDS,FDP,FPL,FCU and FCR. There are associated nerve and arterial damage also might prevail which includes median, radial and ulnar nerve. These kind of injuries are quite complex and are managed by specifically Hand Surgeons. Following post-surgical repair the Physiotherapists and occupational therapists plays a key role during rehabilitation . There are various standard protocols available to treat such cases.IASTM(Instrument Assisted Soft Tissue Mobilization) is one of the effective innovative tool in treating various conditions related to tissue tightness following nonsurgical and post-surgical management .Physiotherapy has diversified its treatment methods over a period of time with the use of various modalities and instruments. Instrument assisted soft tissue mobilization (IASTM) is one of the tool that has gained popularity with its use in treating various pathologies.This case study was done check the effect of KIASTM(Kinesio Instrument Assisted Soft Tissue Mobilization)in treating a post-surgical repair of FDP,FDS and FPL tendons along with median nerve injury following a glass cut penetrating injury on volar surface of right wrist. Case Description: A 34 year old male patient reported for Post-operative rehabilitation of Median nerve injury along with FDP,FDS and FPL tendon repair and also radial and ulnar artery repair. The surgery was performed 20 days prior to start with the physiotherapy treatment. The physical therapy protocol included KIASTM by using the Acceltool, electrical muscle stimulation, exercise therapy including passive stretching and active exercises. The case was evaluated using outcome measures VAS for pain,Goniometry for wrist joint ROM and DASH questionnaire for assessing the upper extremity function pre-treatment and post treatment.Results: It is seen that there were prognosis in overall hand function following Spaghetti wrist injury in terms of pain, AROM and functional ability in post-operative hand rehabilitation.Conclusion: Considerable improvement was seen with the use of KIASTM along with other therapeutic interventions following Spaghetti wrist injury in reducing pain, increasing AROM and improving hand function during rehabilitation in post-operative phase of management