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 Rehabiljournal_title
American journal of physical medicine & rehabilitationauthors
Lee J,Garcia AM,Lee WP,Munin MCdoi
10.1097/PHM.0b013e3182240a73subject
Has Abstractpub_date
2011-08-01 00:00:00pages
688-93issue
8eissn
0894-9115issn
1537-7385pii
00002060-201108000-00011journal_volume
90pub_type
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journal_title:American journal of physical medicine & rehabilitation
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