2011 - 10th Meeting - IHCTAS


This page contains exclusive content for the member of the following sections: TTS, IHCTAS. Log in to view.

Posters

2.15 - REVIEW OF FIRST LOUISVILLE BILATERAL HAND TRANSPLANT REHABILITATION COURSE

Presenter: Anne, Hodges, Louisville, KY, USA
Authors: Laurie Newsome, Anne Hodges, Ashley Buren Emrich, Selena McGill, Christina Kaufman, Brenda Blair

REVIEW OF FIRST LOUISVILLE BILATERAL HAND TRANSPLANT REHABILITATION COURSE

Laurie Newsome1, Anne Hodges1, Ashley Buren Emrich1, Selena McGill1, Christina Kaufman1, Brenda Blair1.

1Christine M. Kleinert Institute, Louisville, KY, USA.

Purpose: Our center recently performed a bilateral hand transplant on a burn patient at the level of the wrist on both hands. We report here the novel challenges of therapy encountered in this case, with respect to the type of transplant as well as the complications and circumstances individual to this patient.

Methods: Initial parameters of treatment were based on our experience with our 5 unilateral patients, and the unique surgical reconstruction in this case. Complications that affected his therapy progress were identified. His usual schedule was 4 hours of therapy 5 days a week, similar to our unilateral patients. Outcomes were measured by range of motion, grip and pinch strengths, sensory return (using tinel’s sign) and Carroll test.

Results:This patient showed excellent early digit motion, with ability on the left to approximate tips to palm on all fingers except small on post op day 2. On the right, he was able to make ¾ full fist with 2-5 fingers. Starting at post op day 14, vascular compromise on the right and resulting surgeries as well as rejection delayed therapy on the right for 8 days. For 7 additional days, on the right, only finger ROM was permitted. On the left, poor wrist extension strength hindered functional gains. Complications resulted in extension of his stay from 90 to 126 days. In spite of complications, our bilateral patient began using his hands for everyday functional tasks 9 ½ weeks post surgery, and gradually added more activities such as shaving, drinking from a cup and water bottle 2 handed, and feeding himself.

Conclusions:Despite multiple complications, this patient has attained good function with his new hands. His outcome measurements at 3 months post surgery, with a few exceptions, were generally similar or superior to our previous unilateral patients.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
info@tts.org

Address

The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada