Definition and Overview

Post-operative mobility of the hands and fingers is a medical intervention performed after surgical procedures with the goal to restore the partial or complete function of the mentioned body parts.

Post-operative care is part of any surgical procedure. It is thoroughly discussed to patients before they undergo surgery and commences as soon as the patient is wheeled out from the operation to the recovery room. It continues even after the patient has already been discharged from the hospital, especially since certain risks and complications can develop after weeks, months, or even years after the surgery.

Post-operative care covers many aspects of post-surgery recovery. These include wound and pain management, rehabilitation of the organ or body part that has been operated on, monitoring of vital signs and progress of the patient, tracking of problems and complications, and management of risks, among others.

This type of care also deals with sarcopenia or the loss of muscle function, strength, and mass. It normally occurs among adults who have spent a good amount of time in bed or has been immobilized for a significant amount of time. As the muscles are lost, the patient would have a more difficult time toward recovery and minimize their sense of independence.

Who Should Undergo and Expected Results

Post-operative mobility of the hands and fingers are expected to be performed on patients who:

  • Have undergone surgical procedures on the upper limbs – Upper limbs consist of the shoulder, arm, and hand. The body is composed of a series of nerves that serves as pathways for signals that are delivered to the brain, including those that are related to pain. This is the reason why when the hands or arms hurt, the pain sometimes travels all the way to the shoulders.

There are many reasons why a person needs to undergo surgery of the upper limbs, but they can be generally classified as a musculoskeletal disorder or trauma. Trauma is a sudden injury to the mentioned body parts. For example, a person can fracture his arm after a fall. Musculoskeletal disorders, on the other hand, may be congenital or a result of wear and tear.

  • Are already aging – Aging presents unique challenges to post-operative care as the immune system may no longer be as robust as when the patient was younger, and the patient can develop muscle atrophy. Seniors often receive post-operative mobility care earlier than young adults, although the steps undertaken may be more gradual.

  • May have lost the function of their fingers and hands for a time – Surgeries can be performed in other sites of the body and still have an impact on the upper limbs, especially the fingers and hands. For instance, the patient may be subjected to a complete bed rest, which means movements are severely limited. It’s also possible that a condition may have prevented the patient from using these body parts. A person can fall into a coma, for example, for some time. Injuries including burns may cause the skin tissues to contract and reduce finger and hand movements.

  • Have been fitted with prosthetics – Whether these prosthetics are temporary or permanent, they create a new normal for the patient.
    Post-operative mobility of the hands and fingers is a must as it offers a wide array of benefits for both the patient and the health provider. It can:

  • Increase the independence of the patient

  • Encourage faster recovery
  • Significantly reduce post-operative risks and complications particularly infection
  • Reduce time spent in the hospital, which can increase infection risk
  • Decrease the chances of hospital re-admissions
  • Promote a more participative treatment approach as families are given an opportunity to assist the patient toward recovery

How Does the Procedure Work?

The discussion about post-operative mobility of the hands and fingers begin during the pre-surgical stage. At this point, the surgeon should be able to educate the patient on the effects of the procedure. Among the details that will be discussed include whether short or long-term recovery is expected, the effects of the procedure on the patient’s quality of life, risks and complications, people in charge of the post-operative care, and possible outcomes of both the surgery and post-operative follow-up.

The post-operative mobility of the hands and fingers can be accomplished in a hospital and/or outpatient setting and is usually accomplished by physical and occupational therapists, with the guidance of the surgeon or an orthopedic specialist. In the beginning, while the patient is still in the hospital, the staff will teach the patient simple motions like moving the fingers or lifting the arms, assisting them if they cannot fully complete the exercise. As the patient regains mobility, however, the rehabilitative sessions will be more regular and defined with set goals that have to be assessed, accomplished, and monitored.

The rehabilitation will be designed based on the needs and expected outcomes of both the patient and the care team. The patient will be taught how to become more independent, and will be provided with instructions and programs that can be performed at any time and at a place that the patient finds comfortable. They can also be monitored wirelessly using new tools like tracking apps and smart watches, which feed health data to a centralized system.

Possible Risks and Complications

Surgery is always a risky procedure but as new methods are being developed, these risks continue to decrease. Nevertheless, one of the biggest challenges with post-operative mobility is the surgery itself. If it has resulted in complications like wound infection, swelling, or bleeding, rehabilitation may be postponed, which can only extend the patient’s recovery period.

Another potential problem is if the patient refuses to cooperate, especially if the results of the procedure is very limited at first. It’s also possible that the patient may develop more dependence on assistive technologies and the support of doctors, carers, and family members.

Also, the outcomes of post-operative mobility may not be achieved, which means the rehabilitation program has to be adjusted continuously. This may also delay complete recovery.

References:

  • Getz CL, Phillips J. Adhesive capsulitis. In: Skirven TM, Osterman AL, Fedorczyk JM, Adadio PC. Rehabilitation of the Hand and Upper Extremity. 6th ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 89.

  • Harris JD, Griesser MJ, Jones GL. Stiff shoulder. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 55.

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