Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 3

Rehabilitation Outcomes After Upper Extremity Replantatio

Banu Dilek 1 ,Selmin Gülbahar 2 ,Kadir Bacakoğlu 3 ,Mustafa Özkan 4 ,Ramazan Kızıl 3 ,Elif Akalın 2
1 Dicle Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Diyarbakır, Türkiye
2 Dokuz Eylül Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İzmir, Türkiye
3 Dokuz Eylul Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Izmir, Türkiye
4 Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, İzmir, Türkiye

Objective: The aim of this study was to evaluate the rehabilitation outcomes after upper extremity replantation.
 

Materials and Methods: Fourteen patients after upper extremity replantation were included in this study. The evaluation parameters were: range of motion, sensorial recovery (static two-point discrimination and Semmens-Weinstein Monofilaments (SWM)), functional evaluation Purdue Pegboard Test (PPT), handgrip and pinch strength. Bilateral comparisons were done between the healthy and replanted extremity. Patient satisfaction with daily life activities  was evaluated with visual analog scale.
 

Results: The mean time period after replantation was 5.36±3.08 years. Handgrip and pinch strength, total active motion (TAM) of fingers, also PPT of replanted extremity were significantly decreased. Patient satisfaction with daily life activities was 6.71±1.43. Two-point discrimination of replanted extremity was found as: one point in seven, poor in one, moderate in three and normal in three patients. Results of the sensory testing: two patients presented with normal sensibility, three were with reduced light touch sensation and five had decreased protective sensibility. Three patients had loss of protective sensibility and one patient had no sensation. 
 

Conclusion: Although muscle strength, functional level, sensation and TAM in replanted extremity were worse after upper extremity replantations, patient satisfaction with daily life activities and the time needed to return to work were found acceptable. 

Keywords : Replantation, upper extremity, functional evaluatio