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Ganjiwale, Deepak
- A Case Report on the Role of Occupational Therapy in Revascularised and Replanted Surgical Case of Flexor Tendon of Hand
Authors
1 K.M.Patel Institute of Physiotherapy Shree Krishna Hospital, Karamsad, Anand, Gujarat, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 5, No 4 (2011), Pagination: 34-39Abstract
Occupational Therapy intervention, after revascularisation/ replant of flexor tendon injury, are very rare . When a primary repair can not be done, tendon reconstruction remains the treatment in such cases. In the past years there have been significant innovations in injury repair and aftercare for patients who sustain different zones of flexor injuries. Based on improvements in our understanding of the mechanism of repair, new differentiated concepts have been developed, but active extension and passive flexion is still the standard in flexor tendon surgery. The new stronger suture techniques today allow immediate active flexion and rehabilitation through Occupational therapy can help in improving the flexion movements faster.
The purpose of this article is to review the occupational therapy intervention of flexor tendon injury after revascularisation / replant.
A case of lacerated wound on right hand, volar aspect near wrist with palmaris longus, flexor carpi ulnaris(FCU), flexor carpi radialis(FCR), flexor digitorum profundus(FDP), flexor digitorum superficialis(FDS), flexor pollicis longus(FPL), ulnar nerve and vessels cut, came to our centre . The tendons were repaired and patient was referred for occupational therapy services. After occupational therapy intervention patient now is able to work independently and has returned to his job back. Even though all the flexor tendons had got cut completely, the patient is today able to perform all functions that he used to do before the accident, again viz: drilling and cutting etc.
Keywords
Occupational therapy, Replant, Revascularisation
- Occupational Therapy Rehabilitation of Post Operative Hand Injury Cases Using Modified Low Cost Splints and Home Based Exercises: A Rural Indian Experience
Authors
1 KMPIP, Shree Krishna Hospital, H. M. Patel Centre for Medical Care & Education, IN
2 Central Research Services & Department of Community Medicine, PSMC, Karamsad, Gujarat, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 8, No 3 (2014), Pagination: 208-213Abstract
Objective: Kleinert (active extension, passive flexion) is basic early motion program for rehabilitation of hand injuries. There have been significant innovations in therapy programme at different zones of tendon injuries in past. The aim of this study was to analyze the functional improvement after a postoperative regimen with use of modified splints and home base activities in combination with Occupational Therapy.
Design: Twenty eight patients with different tendon injuries were retrospectively enrolled in this study from one and a half year of routinely collected data. Gross grip, fine grip and range of motion were measured using JAMAR, pinch O meter and finger goniometer respectively.
Result: Statistically and clinically significant improvement was observed in muscle strength (gross and fine) and range of motion in these patients' hands after modified kleinert splint, custom made splint and home base exercise in all patients (p <0.001 ).
Conclusion: The outcome of the current study i.e. making the patients functionally independent with the use of low cost modified splints and home based exercises, are at par with the other studies that have used standard splints. However postoperative occupational therapy programme is not much documented in literature, although realised and practiced at some places in the western world. This attempt is to produce some evidence of the utility of combination of simple techniques and devices to get optimum results in hand injury cases.