Introduction: Lacerations are one of the most common injuries of upper and lower limbs. Various machines and tools are a common cause of severe lacerations, which in addition to massive injuries of soft tissues, damage nerves, blood vessels and bones. In case of lacerations and gunshot wounds of the hand, rehabilitation is very demanding, due to the involvement of many different structures, their complex anatomy and different rate of healing of various tissues. There are 27 bones, 6 types of joints, hundreds of ligaments, 18 muscles, 28 tendons, several nerves, blood and lymph vessels and skin packed in a very small area. The key to an optimal clinical outcome is a quick, strategically planned and successfully performed surgical procedure followed by an appropriate rehabilitation program, in which physiotherapy plays the key role. Purpose: To present the rehabilitation process after a severe laceration of the patient's hand. The emphasis is on describing the individual physiotherapy program and its effects on hand recovery. Methods: A patient was a 55-year-old man with a laceration of his right hand. Based on continuous physiotherapy assessment, we designed an individual physiotherapy program, which in all phases of the rehabilitation consists of initial tissue preparation and individually tailored therapeutic exercises. For evaluation of progression, we used inspection, palpation, goniometric measurements, manual muscle strength testing, tests of superficial sensation, visual analogue scale for pain assessment and 9-pin test of hand function. Results: The appearance of the hand greatly improved; the fibrous tissue became superficially almost invisible. The tactile capability of morphological structures improved, and joint mobility in all joints was increased after six months of therapy. Manual muscle testing indicates an improvement in muscle performance. Tests of surface touch sensibility indicates the onset of reinnervation of the denervated area. The dexterity and coordination of the hand have improved. Discussion and conclusion: Physiotherapeutic treatment of hand laceration is a demanding process that requires an individual approach. Although the results of this case report cannot be generalized, it can be concluded that the implemented rehabilitation program was very successful for the patient, as we achieved all clinical goals and greatly improved the quality of the patient´s life.
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