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Final Program


Final Program

657 - Healing Hands: Multidisciplinary Approach for Optimal Recovery in Severe Limb Injury

Thursday, February 27, 2025
5:00 PM - 6:30 PM MST
Case Diagnosis: Three months prior to visitation, the patient suffered severe bite wounds to her right upper limb from a 135-pound mastiff, necessitating wound VAC, antibiotic therapy, and secondary closure via skin grafts. Despite initial nerve exposure, the healing process showed remarkable progress with evident aesthetic enhancement. However, notable functional limitations persisted, encompassing restricted elbow range of motion, diminished finger dexterity, and persistent radiating neuropathic pain. Despite dedicated efforts through intensive hand therapy, the patient's progress towards achieving functional goals had been minimal. Following a comprehensive consultation involving the patient, hand therapist, and MSK physician team, a decision was made to administer an ultrasound-guided axillary nerve block (NB) to alleviate pain and paresthesia, thus facilitating further therapeutic interventions and fostering functional enhancement. 

Case Description: An ultrasound-guided right axillary block was successfully performed. Remarkable qualitative and quantitative improvements were observed post-procedure. The patient showed significant enhancements in wrist ROM, including flexion, extension, and abduction, and improved finger flexion, measured by fingertip to distal palmar crease distances. Notably, the patient regained the ability to engage in exercises at the gym and noticeable pain reduction. 

Discussions: This intricate case underscores the critical importance of interdisciplinary care, emphasizing the indispensable collaboration between MSK physicians, hand therapists, residents, and patients to optimize functional outcomes. It highlights the necessity for thorough MSK evaluations and the significance of targeted interventions in achieving comprehensive patient care, as well as underscores the value of ongoing feedback between the treatment teams. 

Conclusions: Findings from these studies strongly advocate for a multidisciplinary MSK approach, which not only enhances patient outcomes but also improves efficiency and reduces waiting times. The collective efforts of diverse healthcare professionals, including MSK physicians, hand therapists, and other specialists, contribute to comprehensive evaluations, tailored interventions, and ultimately, superior management of complex cases such as the one presented.