Upper limb evaluation and splinting with the patient under anesthesia: New approaches in rehabilitation

The rehabilitation process is fundamental for the functional recovery during the pre and postoperative period of surgical cases from complex traumatic lesions of the hand and upper limb. Patient’s functional evaluation is the basis from which the procedures adopted by the hand therapist can be defined, analyzed and modified, according to the needs of each individual during the treatment. Currently, we observe that the rehabilitation beginning has been occurring more and more precociously; mostly on the first or second postoperative day according to the type of injury and the protocol adopted by the surgeon. This is a consequence of surgical techniques advances; more resistant sutures range which allow early passive motion; and the use of smaller incisions that decrease both the region trauma and the inflammatory process at the surgical site. The presence of the hand therapist during the surgical procedure can be of great value. The professional is able to evaluate the affected limb with the patient under anesthesia, which eliminates the "pain" factor. As a result, the therapist can observe more accurately if there are tendon retractions, joint contractures and joint stiffness. These complications are to the medical team so everyone will be aware about the challenges that will be faced during the patient’s rehabilitation and recovery. In addition, the hand therapist is also capable to fabricate splints in the surgical center if necessary. This procedure should be made exactly after the end of the surgery and after the dressing’s construction; in the final moments which the patient is still under anesthesia, aiming the right and best upper limb positioning without causing pain or discomfort to the patient. The hand therapist will continue to treat the patient in the outpatient setting, aiming the recovery of his autonomy and independence to perform ADLs with safety and quality.

Biography :

Mariane Campopiano Abrahão Silva, occupational therapist, graduated from Medical School, University of São Paulo. In 2011, she was awarded with a scholarship from The School of Permanent Education of the University of São Paulo-Faculty of Medicine from Clinics Hospital. She completed the professional training in Occupational Therapy in Plastic Surgery and Burns in 2012 with an average mark of 9.96/10. She completed the Latu Sensu graduate level program of Hand Therapy and Upper Limb Rehabilitation, offered by the Department of Occupational Therapy of the Biological and Health Sciences Center of the Federal University of São Carlos in 2013. Since she graduated, she has been working in renowned Brazilian’s hospitals, with splinting, hand rehabilitation and scientific research about upper limb rehabilitation. She is Member of the Brazilian Society of Hand and Upper Limb Therapy and she has been participating in researches, world congresses and symposia with published papers.

E-mail: mariane_fgl@hotmail.com

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