Progress in microsurgical techniques for the last 40 years revealed a new population of patients: those with replanted hand. We present the case of a 63-year-old patient with a complete traumatic radio carpal amputation. His amputated hand was successfully replanted in emergency on December 8, 2014; we will detail the issues in post-operative rehabilitation treatment and the need to solve multiple problems. We will discuss about vascular question, risk of infection, skin appearance, bone, tendon, neurological, and psychological component, some objectives having to take in consideration different factors involved in the recovery. The replantation of a hand in a 63-year-old patient requires specialized care, long and difficult labor with an uncertain future for reinnervation. On the other side, the myoelectric prosthesis allows to the patient a rapid return to social life.

AIM:To evaluate fear, beliefs, catastrophizing and kinesiophobia in chronic low back pain patients about to begin a training programme in a rehabilitation centre.PATIENTS AND METHODS:Fifty chronic low back pain patients (including both males and females) were assessed in our physical medicine department. We used validated French-language scales to score the patients' pain-related disability, quality of life and psychosocial factors.RESULTS:Seventy percent of the patients had a major functional disability (i.e., a Roland-Morris Scale score over 12) and nearly 73% reported an altered quality of life (the daily living score in the Dallas Pain Questionnaire). Pain correlated with functional impairment and depression but not with catastrophizing or kinesiophobia. Disability was correlated with catastrophizing and kinesiophobia.CONCLUSION:Psychosocial factors are strongly associated with disability and altered quality of life in chronic low back pain patients. Future rehabilitation programs could optimizing patient management by taking these factors into account.

Les progres de la reanimation et de la chirurgie font que l'on sauve de plus en plus de brules graves. Les sequelles sont donc de plus en plus lourdes et les brules doivent vivre avec cette deterioration de leur image mais subissent aussi des traitements contraignants pendant plusieurs annees. Il convient de s'interesser a la qualite de vie de ces patients et de pouvoir la mesurer. A l'heure actuelle, il n'existe qu'une echelle de qualite de vie validee, la Burn Specific Health Scale developpee aux Etat-Unis. Une enquete aupres de professionnels de la brulure puis une autre enquete realisee aupres de 49 patients brules depuis plus de un an et reeduques dans notre centre convergent dans la meme direction. L'adaptation culturelle de la Burn Specific Health Scale ne parait pas adaptee a nos besoins. Une reflexion menee avec les methodologistes semble favoriser l'utilisation d'une echelle generique a laquelle un module specifique de la brulure serait associe.