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Rehabilitation Practice and Science

Translated Title

手部熱壓傷之病患於早期復健介入之過程以一接受腹部皮瓣移植個案為例

Abstract

Machine crush injury is the most common occupational injury in Taiwan. Machines operated at high pressures and temperatures can cause severe injury to the hands. To improve functional recovery of the hands, pedicled groin flap transfer is recommended. This reconstructive option is useful and versatile for covering hand wounds. The transfer yields predictable results with a procedure that is substantially less difficult and takes less time compared with free-tissue transfer; the disadvantage is that the extremity must be immobilized. Pedicled groin flap transfer can cause some complications, such as joint stiffness and edema, which can be prevented through early intervention occupational therapy. We examined a patient with a severe hot crush injury to the left hand and designed an early intervention program after she underwent the flap transfer and K-wire fixation. To prevent adhesions and joint stiffness, we executed passive range of motion（ROM）exercises to the fingers, which were immobilized at the first stage. After removing the K-wires, we began increasing the active ROM of the fingers and reducing the edema through massage. The patient showed significant improvements in the ROM of the metacarpophalangeal joints. Subsequently, we trained the muscle power and dexterity of the hand. Finally, the patient returned to work after aggressive treatment for 3 months. This casereport revealed that providing early intervention for patients who have undergone a pedicled groin flap transfer can significantly improve（1）joint stiffness,（2）edema,（3）muscle power, and（4）ability to perform regular activities of daily living. Thus, we conclude that providing early intervention occupational therapy to patients with severe hand injury is critical for achieving optimal functional outcomes.

Language

Traditional Chinese

First Page

161

Last Page

168

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