Hand Therapy Regimen for Functional Recovery Following Combined Face and Bilateral Hand Transplantation

Area of Science:

• Reconstructive surgery
• Transplantation medicine
• Rehabilitation therapy

Background:

• Hand transplantation (HT) requires intensive rehabilitation for functional recovery.
• A 23-year-old male with extensive burns underwent combined face and bilateral HT.
• A multidisciplinary approach is crucial for selecting HT candidates.

Purpose of the Study:

• To present a detailed 4-phase hand therapy protocol for a combined face and bilateral HT recipient.
• To highlight the importance of individualized rehabilitation in complex transplant cases.
• To share insights into managing post-transplant care for hand allografts.

Main Methods:

• Protocol development included pre-surgery planning, ICU/acute care, inpatient rehabilitation, and outpatient phases.
• Interventions focused on orthotics, allograft protection, edema/wound management, neuromuscular and sensory re-education, strength/flexibility training, ADL training, and HEP.
• Patient education for caregivers and the patient was integral throughout the process.

Main Results:

• The patient demonstrated significant functional improvement post-transplant compared to pre-operative status.
• The comprehensive protocol facilitated improved range of motion and independence in daily activities.
• Allograft protection and management were key components during the acute phases.

Conclusions:

• An individualized, phased rehabilitation program is essential for successful outcomes in hand transplantation.
• This protocol provides a framework for managing complex HT cases.
• Effective hand therapy maximizes functional recovery and patient independence after transplantation.