Essentials of physiotherapy after degloving injury in a 45-year-old male

Nupur Thombare, Gunjan Shende, Tejaswini B. Fating, Pratik Phansopkar, Neha Chitale, Om C. Wadhokar

Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

ABSTRACT

Injuries are most often caused by road traffic collisions and manufacturing accidents. They emerge from a large rotational force from the underlying fascia, which avulses the skin and subcutaneous tissue. The lower extremities are involved in the majority of such injuries. The patient was a 45-year-old visited Surgery department with complaints of pain on right foot and wound over dorsal aspect of the foot and ankle since day 1 with a history of crush injury to right leg and foot by machine(conveyer) in a factory. Patient developed pain which was sudden in onset and gradually progressive which was aggravated by movement and relieved by medication. investigations showed grade 3 medial malleolus fracture and 1st metatarsal fracture right side. Lacerated wound present over distal 1/3rd and distal 1/4th of right leg along with neovascular deficit. Patient undergone open reduction and k wire fixation with debridement and VAC application under spinal anaesthesia. After which he was referred to physiotherapy department for rehabilitation. This case study shows that proper plan for management is very necessary in order to make patient independent following degloving injury. The exercises and mobility improve patient’s quality of life. Physiotherapy treatment protocol was given for about 6 months, patient was again reassessed and then prognosis was made. Now he is able to perform activities of daily living. He is now able to walk.

Keywords:

Degloving injury, Crush injury, Rehabilitation.