Rehabilitation in Congenital Hand and Forearm Defects: Rehabilitation of the Child’s Hand—General Aspects

Abstract

Patients affected by radial club hand present different aspects all involving the general use of the entire upper limb: shorter forearm, radial deviation, low to severe dysfunction of the thumb or in the most severe stages, its absence and reduced AROM (active range of motion) of long fingers.

The major problem during the growth of those patients is the frequent recurrence of relapses that may occur despite the kind of surgery performed: this can be due to different causes linked both to intrinsic factors such as the impossibility of releasing radial soft tissues completely or extrinsic elements such as the poor use of a proper splint and the frequent stimulus to the radial deviation due to functional gestures like bringing the hand to the mouth. Unfortunately, the clinical situation can be considered stabilized only with the end of physiological bone growth.

The rehabilitation programme begins taking charge of the patient after the first visit with the surgeon. It is divided in two different approaches:

• Conservative treatment: it starts immediately after the visit and lasts in the pre-operative time.

• Post-surgery treatment: it starts after the surgery.

In both, the treatment is endorsed by the surgical team, the therapist and the patient’s family, who becomes both a receiver and an active participant in the rehabilitation process.