Opponens plasty rehabilitation protocol--a case report

Hand therapy for dysfunction of the intrinsic muscles

Intrinsic muscle dysfunction can be devastating. Patients often have difficulty using the affected hand for most daily activities. Physicians, occupational therapists, and patients have to work together to enable the patient to regain functional use of the hand to perform activities that are a part of their life roles. Occupational therapists play an important role in the rehabilitation process to regain motion, strength, and dexterity so that patients can use the hand more functionally. Patient education and active participation in their therapy is also essential in the functional recovery of the hand.

Rehabilitation for bilateral amputation of fingers

We describe reconstructive surgeries, therapy, prostheses, and adaptations for a patient who experienced bilateral amputation of all five fingers of both hands through the proximal phalanges in January 1992. The patient made considerable progress in the use of his hands in the 10 mo after amputation, including nearly a 120% increase in the active range of flexion of metacarpophalangeal joints. In late 1992 and early 1993, the patient had "on-top plasty" surgeries, in which the index finger remnants were transferred onto the thumb stumps, performed on both hands. The increased web space and functional pinch resulting from these procedures made many tasks much easier. The patient and occupational therapists set challenging goals at all times. Moreover, the patient was actively involved in the design and fabrication of all prostheses and adaptations or he developed them himself. Although he was discharged from occupational therapy in 1997, the patient continues to actively find new solutions for prehension and grip strength 18 yr after amputation.