From Limb Salvage to Prosthetic Rehabilitation After Severe Traumatic Hand Injury Complicated by Complex Regional Pain Syndrome: A Case Report
4 affiliations
- 1Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- 2Department of Anesthesiology, Intensive Care Medicine and Pain Management, University Hospital Centre Osijek, 31000 Osijek, Croatia
- 3Palliative Care Department, Osijek-Baranja County Health Center, 31000 Osijek, Croatia
- 4Department of Health Studies, Lavoslav Ružička Polytechnic in Vukovar, 32000 Vukovar, Croatia
Abstract
Background/Objectives: Severe traumatic injuries of the upper extremity present a major therapeutic challenge because of extensive tissue damage, severe pain, loss of function, and substantial psychosocial consequences. Continuous multidisciplinary rehabilitation that adapts to the patient’s evolving clinical condition may optimize functional outcomes across the entire continuum of care. Methods: A 42-year-old man with no prior comorbidities sustained a severe work-related traumatic injury to his left hand. Despite reconstructive surgery and prolonged multidisciplinary treatment, he developed CRPS with persistent neuropathic pain, progressive functional deterioration, and psychological distress. Fourteen months after injury, the affected limb became completely nonfunctional, and elective transradial amputation was recommended after multidisciplinary evaluation. Results: Rehabilitation was delivered as a continuous, phase-adapted multidisciplinary program. Before amputation, treatment focused on pain control, reduction of edema and inflammation, preservation of joint mobility and muscle function, and management of CRPS using multimodal physical therapy combined with pharmacological treatment and psychological support. As amputation became inevitable, rehabilitation goals shifted toward pre-amputation preparation, promotion of adaptive neuroplasticity, and prevention of phantom limb pain. After transradial amputation, pain intensity markedly decreased, functional adaptation improved, and the patient successfully completed prosthetic rehabilitation. Conclusions: This case highlights the importance of a continuous, individualized multidisciplinary rehabilitation strategy extending from limb salvage through post-amputation recovery. Integrating multimodal physical therapy, neuroplasticity based interventions, psychological support, and prosthetic rehabilitation may improve pain control, facilitate functional recovery, and enhance long-term adaptation after severe traumatic upper extremity injury.
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BibTeX
@article{tot2026from,
title = {{From Limb Salvage to Prosthetic Rehabilitation After Severe Traumatic Hand Injury Complicated by Complex Regional Pain Syndrome: A Case Report}},
author = {Ozana Katarina Tot and Anja Petričević and Dijana Hnatešen and Ana Cicvarić and Iva Dimitrijević and Vanja Matković},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208000},
url = {https://www.mdpi.com/2077-0383/15/20/8000},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - From Limb Salvage to Prosthetic Rehabilitation After Severe Traumatic Hand Injury Complicated by Complex Regional Pain Syndrome: A Case Report
AU - Ozana Katarina Tot
AU - Anja Petričević
AU - Dijana Hnatešen
AU - Ana Cicvarić
AU - Iva Dimitrijević
AU - Vanja Matković
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208000
UR - https://www.mdpi.com/2077-0383/15/20/8000
AB - Background/Objectives: Severe traumatic injuries of the upper extremity present a major therapeutic challenge because of extensive tissue damage, severe pain, loss of function, and substantial psychosocial consequences. Continuous multidisciplinary rehabilitation that adapts to the patient’s evolving clinical condition may optimize functional outcomes across the entire continuum of care. Methods: A 42-year-old man with no prior comorbidities sustained a severe work-related traumatic injury to his left hand. Despite reconstructive surgery and prolonged multidisciplinary treatment, he developed CRPS with persistent neuropathic pain, progressive functional deterioration, and psychological distress. Fourteen months after injury, the affected limb became completely nonfunctional, and elective transradial amputation was recommended after multidisciplinary evaluation. Results: Rehabilitation was delivered as a continuous, phase-adapted multidisciplinary program. Before amputation, treatment focused on pain control, reduction of edema and inflammation, preservation of joint mobility and muscle function, and management of CRPS using multimodal physical therapy combined with pharmacological treatment and psychological support. As amputation became inevitable, rehabilitation goals shifted toward pre-amputation preparation, promotion of adaptive neuroplasticity, and prevention of phantom limb pain. After transradial amputation, pain intensity markedly decreased, functional adaptation improved, and the patient successfully completed prosthetic rehabilitation. Conclusions: This case highlights the importance of a continuous, individualized multidisciplinary rehabilitation strategy extending from limb salvage through post-amputation recovery. Integrating multimodal physical therapy, neuroplasticity based interventions, psychological support, and prosthetic rehabilitation may improve pain control, facilitate functional recovery, and enhance long-term adaptation after severe traumatic upper extremity injury.
SN - 2077-0383
ER -