Functional recovery after earthquake-related severe upper extremity crush injury: A case report of staged hand reconstruction and rehabilitation.

BACKGROUND: Earthquake-related crush injuries may cause acute compartment syndrome leading to severe muscle and nerve damage, and comprehensive rehabilitation following surgery plays a critical role in recovery. PURPOSE: To describe functional outcomes of staged surgical interventions combined with a structured rehabilitation program in a patient with earthquake-related right forearm compartment syndrome. STUDY DESIGN: Case report. METHODS: A 23-year-old male patient underwent emergency fasciotomy for acute forearm compartment syndrome, followed by staged reconstructive surgeries. Following the major functional reconstructive procedures (free gracilis muscle transfer and Brand tendon transfer), individualized rehabilitation programs were implemented, including orthotic positioning, neuromuscular electrical stimulation, sensory and motor re-education, progressive strengthening, and functional upper extremity training. RESULTS: After rehabilitation, notable improvements were observed in joint mobility, muscle strength, and upper extremity function. These gains were supported by increases in Michigan Hand Outcomes Questionnaire scores (hand function: 30-70; activities of daily living: 31-59; work: 0-45; satisfaction: 17-79), with sustained improvements at follow-up. CONCLUSIONS: An interdisciplinary approach integrating staged surgical management with individualized rehabilitation can enhance sensorimotor recovery and functional outcomes in patients with severe forearm compartment syndrome following an earthquake.