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Protocollen handtherapie

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daan wessing

on 24 August 2014

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Transcript of Protocollen handtherapie

Protocollen handtherapie
(Gemodificeerde) Brunelli-plastiek
Three-ligament tenodesis 3LT
Opheffen rotatoire subluxatie scaphoid,
SL-dissociatie
Voorkomen SLAC wrist
en artrose
Primaire doel ingreep:
Volgens de literatuur: voorkomen/ verminderen DISI röntgenbeeld
Secundaire doel ingreep:
4 weken K-draden + gips
Waarna start onbelast polsprogramma
Voorkeur: Geen spalk
Postoperatief beleid Hand Clinic
Postoperatief beleid Literatuur
Consensus over postoperatieve beleid
Green’s operative hand surgery
Green, David P., e.a. (2005) Green’s operative hand surgery, fifth edition. Elsevier Churchill livingstone. Chapter 14, page 566-567 and page 573-574
Operative techniques in hand, wrist and forearm surgery. Hunt
Nieuwe therapie richtlijn:
6 weken K-draden + gips
6 weken afneembare spalk + oefentherapie (polsprogramma)
Na 12 weken kracht opbouwen
Na 6 maanden hervatten contact sporten
Rehabilitation of the hand and upper extremity
6 weken gips (pols + MCP-I) +
4 weken afneembare spalk (pols + MCP-I) en
6 weken K-draden
Na 6 maanden weer contact sporten
Outcome: geen pijn, verlies 20 graden flexie
75% grip strength
8 weken gips (pols + MCP-I) +
4 weken afneembare spalk (pols + MCP-I) en
8 weken K-draden
Outcome: geen/ minder pijn, verlies 31% flexie
80% grip strength
Skirven, Terri M., e.a. (2011) Rehabilitation of the hand and upper extremity, sixth edition. Elseviers Mosby. Chapter 73, page 995. And chapter 74, page 1002-1009
Thomas R. Hunt e.a. (2011) Operative techniques in hand, wrist and forearm surgery. Wolters Kluwer health. Section V wrist instabilities, chapter 44, page 390-395
6 weken gips (pols + MCP-I) +
4 weken afneembare spalk (pols + MCP-I) en
6-8 weken K-draden
Garcia-Elias et all (2006)
"A short-arm thumb spica cast is placed, changed at 10 days for stitch removal, and maintained for a total of 6 weeks. A protective removable splint allowing supervised rehabilitation is used for an additional 6 weeks. Wires are removed 8 weeks after surgery.
Contact sports are to be avoided for 6 months after surgery."
6 weken K-draden + gips
Waarna start onbelast polsprogramma
Voorkeur: beschermende spalk
EN/ OF
Full transcript