Physiotherapy programme after toe-to-index transplantation: a case report

Year 2013, Volume: 3 Issue: 2, 91 - 96, 30.01.2014

Zeynep Tuna Deran Oskay , Serhan Tuncer

Abstract

Objective: The aim of this case report is to make a partly contribution to the literature about the physiotherapy assessment and treatment methods after toe-to-hand transplantations and to report the results of the treatment program. 

Methods: Our patient is a 17-year old boy with a traumatic second and third finger amputation. One year later the injury, he underwent a transplantation surgery that left second toe was transferred as the right index finger. After immobilization of 4 weeks, he was directed to physiotherapy programme that was planned in 3 steps. The first stage of treatment was early rehabilitation. At this stage, through the post-operative 8th week, we aimed to control edema and increase the range of passive and active-assistive motion. Between the 8th and 12th weeks resistance exercises of the transplantated finger were added to the programme. After the 12th week, return to daily life activities was the target of late stage physiotherapy programme. 

Results: Post-operative 4th, 8th and 12th week assessments revealed that the range of motion and the grip and pinch strengths of the transferred finger increased while the most significant increase was seen in the pinch strengths. Moreover, functional test score and disability rate, which are both the indicators of the patient’s functional level, improved gradually. Besides meeting a young patient’s aesthetic deficit by the transplantation surgery, the functional benefits of a well-established post-operative physiotherapy programme were inavoidable. 

Conclusion: It is suggested that physiotherapists would contribute to the patient’s functional recovery by applying a patient-tailored treatment programme.

Key words: Toe-to-hand transplantation, physiotherapy, hand function

Keywords

Toe-to-hand transplantation, physiotherapy, hand function

Ayaktan indekse transplantasyon sonrası fizyoterapi programı: Olgu sunumu

Abstract

Amaç: Bu olgu sunumunun amacı, parmak transplantasyonu sonrası uygulanan fizyoterapi değerlendirme ve tedavi yöntemleri konusunda literatüre katkıda bulunmak ve bu tedavi programının sonuçlarını sunmaktır. 

Yöntemler: Vaka; sağ el 2. ve 3. parmakta travmatik amputasyon meydana gelmiş 17 yaşında erkek hastadır. Yaralanmadan 1 yıl sonra sol ayak 2. parmağı, sağ el indekse transplante edilmiştir. Dört haftalık immobilizasyon sonrası fizyoterapi için yönlendirilen hastanın tedavisi üç aşamalı olarak planlanmıştır. Birinci aşama erken dönem rehabilitasyondur. Cerrahi sonrası 8. haftaya kadar devam eden bu aşamada ödem kontrolü, pasif ve aktif-asistif eklem hareketinin arttırılması planlanmıştır. 8 ve 12. haftalar arasında programa transplantasyona yönelik dirençli egzersizler eklenmiştir. 12. haftadan sonraki geç dönem rehabilitasyon programında ise günlük yaşama geri dönüş hedeflenmiştir. 

Bulgular: Cerrahiden sonraki 4.,8. ve 12. haftalarda yapılan değerlendirmelerde transfer edilen parmağın eklem hareket açıklığı ve kavrama kuvvetlerinde artış olduğu görülmüş, en fazla artışın pinch kuvvetlerinde olduğu dikkati çekmiştir. Ayrıca, fonksiyonellik ölçütü olan el fonksiyon testi ve özür seviyesi skorlarında gelişmeler kaydedilmiştir. Cerrahi sonrası uygulanan planlı fizyoterapi programı ile hastada fonksiyonel kazanç sağlanmıştır.

Sonuç: Hastaya uygun planlanan fizyoterapi programı ile, hastanın fonksiyonel geri dönüşüne katkıda bulunulacağı düşünülmektedir.

Anahtar Kelimeler : Parmak transplantasyonu, fizyoterapi, el fonksiyonu

Keywords

Parmak transplantasyonu, fizyoterapi, el fonksiyonu

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