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

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.