Rehabilitation aims to restore function and autonomy in daily life and is therefore aimed at the recovery of motor functions that have been reduced or lost because of an illness, even chronic, or of a major trauma for which it may be necessary also the orthopedic surgery.

We therefore distinguish between conservative rehabilitation and post-surgical rehabilitation.

In some cases, in order to achieve the functional objective in the shortest possible time and reach full autonomy, paradoxically, a pre-operative physiotherapy or “pre-surgical rehabilitation rehabilitation” can be carried out.

• Pre-surgery rehabilitation: This is for example the case of a hip or knee prosthesis, or even anterior cruciate ligament (LCA) reconstruction, in which a recovery of muscle tone-trophism of one or more muscles, so that as a result of the intervention there is no further muscle loss thus preventing amyotrophy, and thus facilitating recovery in post-surgery. Furthermore, by doing so, the patient can learn the selective muscle recruitment of one or more muscles, that is to be able to send them in contraction, to “command” them, or to learn in advance to walk on crutches and how to face the ascent and descent of steps and stairs.

 

• Conservative rehabilitation: the aim is to resolve and / or reduce inflammation and pain, in addition to the normal restoration of joint excursion, by means of manual treatments (kinesitherapy) and the most modern instrumental therapies such as tecartherapy, laser nd: high power yag, the shock wave, without neglecting the classic physical means such as tens, ultrasound etc.

Subsequently, the physiotherapeutic work will focus on the recovery of the muscular throne-trophism, of proprioceptivity and therefore on the limb control in space, responding to stimuli, external perturbations, and then summarizing its overall stability.

• Post-surgical rehabilitation is necessary early as a result of a surgical procedure to recover the R.O.M (range of motion) as soon as possible, ie the joint movement excursion; to reduce post-surgical edema rapidly through mobilization and manual lymphatic drainage; restore muscle tone-tropism as soon as possible; to prevent, above all, complications induced by immobility (or hypomobility) of the limb which would greatly limit joint recovery and its general function, due to a lack of tissue flow between them and their proper blood supply.

This, for example, becomes essential following the hand surgery that if not followed by an early rehabilitation, is able to develop tissue adhesions, induced by more or less extensive scars in a space however small, that for the particularity of its anatomical structures, sees numerous fabrics interposed between them in a very small space.

In this case it becomes fundamental to be cautious and gradual at the same time, wisely modulated by the experience of the physiotherapist experienced in rehabilitation of the hand, who knows when it is right to force or not the joint recovery because its treatment requires specific skills and knowledge.

The manual treatment of scars is also extremely important as a result of a separation massage.

The hand is a complex organ that responds with particular reactions to a trauma, an immobilization, or to a pathology reacting with peculiarities that differentiate it from any body district (eg shoulder-hand syndrome or sudeck).

The hand is the part of the body that has more sensitive afferents and motor efferences and for this it is more represented in the omunculus in neurophysiology.

Furthermore, it is the “organ” that, if compromised, can generate an important disability or even permanent disability.

So it is essential to rely on orthopedic surgeons who use:

• More and more invasive mini-surgical techniques that involve less invasiveness and respect of the tissues that make the surgical procedure the least cruel possible;
• High specialization on specific techniques to deal with fine hand operations.
• Competence in the treatment of diseases caused by trauma, excessive use, congenital or acquired deformity.

A milestone for success is a communication between the operators (orthopedist, physiotherapist, orthopedic technician), periodic checks, an initial, intermediate and final assessment