Outcome of combined physiotherapy treatment with dynamic splinting in patient with traumatic hand injury: A case report

Abstract

Introduction: Hands are highly susceptible to traumatic injuries, the treatment of which can often result in postoperative complications such as hand stiffness. This study reports the effectiveness of physiotherapy combined with dynamic splinting in managing traumatic hand injuries. Problem Statement and Approach: This case report features a 28-year-old male who sustained a traumatic injury in the third finger of his left hand. Materials and Methods: The patient was referred to the Physical Medicine and Rehabilitation Clinic at the University Clinical Centre of Kosovo, 11 weeks after surgery. Initial physical examination revealed that the hand was painful and swollen. There was also a partial disappearance of the lines of the palm, with redness and severe limitation in the movement of the wrist and fingers. Treatment began 11 weeks after the surgery and lasted for six months. Before commencing physiotherapeutic treatment, which consisted of electrotherapy, active/passive movement, scar management, mirror therapy, muscle strength exercises, coordination, and application of a dynamic splint to achieve a range of motion, hand assessment was done at the baseline after two, four, and six months. Pain was assessed using the verbal numerical scale (VNS) and the range of motion was measured using a goniometer. These values were presented according to Total active/passive motion (TAM Classification). Further, grip strength was assessed using the Jamar dynamometer. Results: Reduction in pain, and improvement in range of motion and muscle strength were observed. The pain reduced from 9 of 10 to 2 of 10; the total passive range of motion in the third finger increased from 30 ̊ to 160 ̊; the total active range of motion increased from 0 ̊ to 100 ̊; and the grip strength increased from 3.3 kg after two months to 14.5 kg, six months after injury. Conclusion: Following a traumatic hand injury, tailored combined physiotherapy treatment played a crucial role in restoring the functionality of the hand, by decreasing the pain, and improving the range of motion, muscular strength, and coordination.