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

Abstract

Study designCase report. IntroductionReports of comprehensive rehabilitation following hand replantation are limited. Purpose of the studyTo describe hand therapy of a patient following hand replantation. MethodsRight 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. ResultsHand 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. DiscussionHand therapy allowed for near complete functional return of the hand following replantation. ConclusionComprehensive Hand therapy aided restoration of adequate sensation and strength for functional use of the replanted hand. Level of evidence4