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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Hand therapy following post-traumatic metacarpophalangeal joint arthroplasty and prevention of potential complications: a case report

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  • presenting/speaker Zeynep Tuna - Gazi University, Ankara, Turkey
  • Mustafa Sari - Lokman Hekim University, Ankara, Turkey
  • Deran Oskay - Gazi University, Ankara, Turkey

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1204

doi: 10.3205/19ifssh1472, urn:nbn:de:0183-19ifssh14725

Published: February 6, 2020

© 2020 Tuna et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The purpose of this case report is to contribute to the literature on the treatment methods of physiotherapy following metacarpophalangeal (MCP) joint arthroplasty and to present the results of our treatment program. We also would like to present the potential complications during hand therapy period and precautions taken for them.

Materials and Methods: The patient was a 27-year-old male military staff with a left hand traumatic injury. One year after injury, MCP joint was replaced with a pyrocarbon implant. His treatment was planned at four consecutive stages from early interventions and patient education to the late-term rehabilitation program targeting return to work and daily life. Regular and careful assessments of range of motion, strength, functions and disability level were performed.

Results: The patient was assessed at the 4th, 8th, 12th and 16th weeks after the surgery. The results of range of motion, grip and pinch strength, functional test and disability level all improved with the treatment program. Initial signs of 2 potential complications were also noted and precaution was taken. Firstly, angulation of the finger appeared in the early phase and a simple splinting was applied to prevent it. Secondly, distal interphalangial extension deficit possibly due to extensor tendon splitting during surgery was noticed. A hyperextension support was added to the splint. Counteracting exercises were also emphasized for both potential deformities.

Conclusions: Patient-tailored physiotherapy program provided significant functional improvements after post-traumatic MCP arthroplasty. Besides, signs of potential complications were recognized through regular assessments and further deformities were prevented by early interventions.