Postoperative rehabilitation of spaghetti wrist: A case report

ObjectiveThis case report presents a comprehensive rehabilitation protocol and outcomes for zone 5 forearm injuries involving tendons and neurovascular structures. Phase-specific rehabilitation strategies were used to maximize functional recovery. The findings provide clinical guidance for managing this rare injury, offering insights into rehabilitation approaches and expected outcomes.DesignCase Report.ParticipationA 46-year-old right-handed male sustained a severe glass-induced open forearm injury during badminton. Emergency surgery revealed complete ruptures of: vascular structures (radial artery, ulnar artery and vein), nerves (ulnar, median, and little finger digital nerves), and tendons (flexor pollicis longus, flexor digitorum profundus and superficialis of digits 2-5, flexor carpi radialis, flexor carpi ulnaris, and palmaris longus)Rehabilitation ProgramA 7-month progressive rehabilitation protocol was implemented for zone 5 flexor tendon injuries with ulnar/median nerve damage, with adjustments based on recovery progress.Outcome MeasuresPostoperative rehabilitation progress was assessed through clinical and functional measures.ConclusionEarly surgery combined with a structured rehabilitation protocol achieved excellent functional recovery, with 70-90% wrist and digit range of motion restoration, improved grip strength and activities of daily living by 12 weeks, progressive sensorimotor recovery between 20-28 weeks, and successful work return by 10 weeks, demonstrating this protocol's efficacy for complex neurotendinous injuries.