Replante üst ekstemitede rehabilitasyon sonuçlarımız

Kadir BACAKOĞLU, Mustafa ÖZKAN, Selmin GÜLBAHAR, Elif AKALIN, Ramazan KIZIL, Banu DİLEK

Özet

Amaç: Üst ekstremite replantasyonu sonrası rehabilitasyon sonuçlarının değerlendirilmesi. Gereç ve Yöntem: Çalışmaya üst ekstremite replantasyon cerrahisi sonrası 14 hasta alındı. Hastaların eklem hareket açıklıkları, duyu değerlendirmeleri (statik iki nokta ayrımı ve Semmens Weinstein Monoflamanları (SWM) ile) fonksiyonel değerlendirmeleri (Purdue Pegboard Test (PPT) ile), el kavrama ve lateral pinç güçleri etkilenmeyen ekstremite ile karşılaştırıldı. Hastaların günlük yaşam aktivitelerinde memnuniyeti 10 cm’lik vizüel analog skalayla değerlendirildi. Bulgular: Çalışmaya alınan hastaların replantasyon sonrası geçen süre ortalama 5,36±3,07 yıl olarak bulundu. Etkilenen tarafta el kavrama, lateral pinç güçleri, parmaklarda total aktif hareket (TAH) ölçümleri etkilenmeyen tarafa göre düşük saptandı ve PPT de daha kötü bulundu (p

Abstract

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.