Revisión sistemática del tratamiento de fisioterapia en el reimplante de extremidad superior

Abstract

ObjectiveDescribing the techniques of physiotherapy implemented in post-surgical treatment of upper extremity replantation and evaluate the functional results. Search strategy and article selectionSystematic review of Pubmed, Web of Science, Scopus and Cochrane Library from 1st January 1990 to 30th June 2015. Two independent reviewers have examined, analyzed and evaluated the results. It has included original studies of patients with upper limb replantation, in which is described and analyzed physiotherapy treatment and outcomes. Summary of resultsSix publications have been obtained, all of them case studies, about 6 replantations of forearm-hand and one of all digits of both hands. The interventions in immediate postoperative period have been the placement of orthosis, state inspection of the replantation, breathing exercises, health education, drainage of edema, and controlled mobilization of the replanted member and the rest of the limb. In ambulatory phase it has been proposed to continue the passive, assisted and active controlled mobilization; drainage of edema; scar massage; electrotherapy; sensory reeducation and retraining of the activities of daily living. Presence of variability at the start of physical therapy and its techniques, especially in joint mobilization. ConclusionsThe study warns of the paucity of references to physical therapy in the biomedical literature, despite being indispensable and vital to successful of the replantation.