RESUMEN
STUDY DESIGN: Case report. INTRODUCTION: Congenital radioulnar synostosis (CRUS) is a rare malformation that causes the restriction of the rotational movements of the forearm, and it is common in congenital elbow anomalies. PURPOSE OF THE STUDY: The aim of this case report was to present the results of physiotherapy in a patient with CRUS who did not undergo surgery. METHODS: A 7-year-old male patient with CRUS began outpatient physical therapy. The child underwent a physiotherapy program for a total of 10 weeks in the presence of a physiotherapist, 2 days per week, and with a home schedule at other times. Observational posture assessment, range of motion measurements of the upper extremities, the Jebsen-Taylor Hand Function Test, finger and hand grip strength, and Canadian Occupational Performance Measure were used to evaluate the patient before and after the physiotherapy program. RESULTS: An increase in Jebsen-Taylor Hand Function Test, Canadian Occupational Performance Measure, and grip strengths were found; however, there was no change in the range of motion values for our patient. DISCUSSION: This report contains physiotherapy results of a patient with CRUS who did not undergo surgery. Further short- and long-term follow-up studies are needed to demonstrate the effects of physiotherapy on surgical and nonsurgical patients with CRUS. CONCLUSIONS: Physiotherapy can be effective in the functional use of the upper extremities in patients with CRUS who do not undergo surgery; long-term follow-up would demonstrate whether functional changes are permanent over time.
Asunto(s)
Anomalías Múltiples/rehabilitación , Deformidades Congénitas del Pie/rehabilitación , Deformidades Congénitas de la Mano/rehabilitación , Modalidades de Fisioterapia , Sindactilia/rehabilitación , Niño , Humanos , MasculinoRESUMEN
BACKGROUND: Traumatic injuries are the most common cause of finger amputations. Therapeutic amputations are less common but may be essential in some patients with congenital malformations of digits. CASE DESCRIPTION AND METHODS: A 21-year-old female patient reported for esthetic management of malformed middle and ring finger of right hand. Examination revealed clino-syndactyly with unusual dermatoglyphics. She was successfully rehabilitated by collaborative efforts of plastic surgeon and prosthodontist, by therapeutic amputation with surgical recontouring and fabrication of somatoprosthesis. FINDINGS AND OUTCOMES: The patient was satisfied with esthetics of the prosthesis and somatoprosthesis improved function. At 6-month recall, no alterations or repair of prosthesis was required. CONCLUSION: Individualized treatment planning with integration of modifications involving a multidisciplinary approach is required to meet needs of patients with congenital digital malformations. The duplication of unusual dermatoglyphics made the prosthesis more realistic. CLINICAL RELEVANCE: An individualized treatment plan with modifications to conventional techniques is required to cater to rehabilitative needs of patients with congenital digital malformations.
Asunto(s)
Amputación Quirúrgica , Miembros Artificiales , Sindactilia/rehabilitación , Dermatoglifia , Estética , Femenino , Humanos , Diseño de Prótesis , Sindactilia/patología , Adulto JovenRESUMEN
Microsurgical nerve lengthening was performed in two siblings presenting a popliteal pterigium syndrome with a knee flexion contracture of 80 degrees. After the first attempt for nerve lengthening and knee extension elsewhere, a repeated lengthening was required due to continuing tip-toe walking and recurrent knee contracture at the age of 3 years. An extensive external and internal interfascicular microsurgical neurolysis resulted in a lengthening of the nerves. A full length of leg procedure had to be performed, inclusive of Achilles tendon lengthening to obtain a complete extension of the knee and a 90-degree ankle flexion. Maintaining the leg in a fully extended position was obtained with a dynamic splinting in the first month after the operation. When timing the operation we have to consider the importance of adequate precision of the microsurgical neurolysis, down to the identification of the Fontana bands, and the adequate postoperative splinting.
Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Contractura/cirugía , Anomalías del Ojo/cirugía , Dedos/anomalías , Marcha , Articulación de la Rodilla/anomalías , Rodilla/inervación , Rodilla/cirugía , Deformidades Congénitas de las Extremidades Inferiores/cirugía , Expansión del Nervio/métodos , Procedimientos de Cirugía Plástica/métodos , Complicaciones Posoperatorias/cirugía , Sindactilia/cirugía , Anomalías Urogenitales/cirugía , Anomalías Múltiples , Niño , Labio Leporino/fisiopatología , Labio Leporino/rehabilitación , Fisura del Paladar/fisiopatología , Fisura del Paladar/rehabilitación , Contractura/fisiopatología , Contractura/rehabilitación , Anomalías del Ojo/fisiopatología , Anomalías del Ojo/rehabilitación , Dedos/fisiopatología , Dedos/cirugía , Humanos , Articulación de la Rodilla/fisiopatología , Articulación de la Rodilla/cirugía , Deformidades Congénitas de las Extremidades Inferiores/fisiopatología , Deformidades Congénitas de las Extremidades Inferiores/rehabilitación , Masculino , Microcirugia , Bloqueo Nervioso , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/rehabilitación , Rango del Movimiento Articular , Procedimientos de Cirugía Plástica/efectos adversos , Reoperación , Hermanos , Férulas (Fijadores) , Sindactilia/fisiopatología , Sindactilia/rehabilitación , Factores de Tiempo , Resultado del Tratamiento , Anomalías Urogenitales/fisiopatología , Anomalías Urogenitales/rehabilitaciónRESUMEN
Syndactyly reconstruction is one of the more common congenital malformations treated by hand surgeons. Most techniques require full thickness skin grafts for coverage. Methods of reconstruction without skin grafts have recently been described and outcomes are generally good. Both techniques are detailed here.