Inpatient rehabilitation challenges in a quadrimembral amputee after bilateral hand transplantation.

Abstract:

:Bilateral forearm and hand transplantation poses unique challenges especially in the setting of bilateral lower limb amputations. A 57-yr-old man with bilateral transradial amputations and bilateral transtibial amputations after remote streptococcal sepsis was admitted for inpatient rehabilitation because of severe debilitation after forearm/hand transplantations. He required 6 wks of bed rest to allow the healing of the allografts but developed profound deconditioning. Because of weight-bearing precautions and other complications such as femoral neurapraxia, he required the use of body weight-support apparatus to ambulate with lower limb prostheses, keeping weight off the allografts. He progressed to walking 600 ft using a platform-wheeled walker at a modified independent level, to climbing four stairs with minimal assistance, and to being able to toss a small football using his right hand, indicating improved flexor function in this hand. Tacrolimus levels were maintained without clinical evidence of acute rejection. Through an individualized therapy regimen, careful monitoring of the allografts and dedicated support staff, rehabilitation training of a previous quadrimembral amputee after bilateral hand transplantations can be successful.

journal_name

Am J Phys Med Rehabil

authors

Lee J,Garcia AM,Lee WP,Munin MC

doi

10.1097/PHM.0b013e3182240a73

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

688-93

issue

8

eissn

0894-9115

issn

1537-7385

pii

00002060-201108000-00011

journal_volume

90

pub_type

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