Comprehensive rehabilitation of patients after multi-organ and multi-focal injuries.

Background. The number of persons in rehabilitation after multi-organ, multifocal injuries increases every year. The purpose of this article is to draw attention to the orthopedic problems associated with the treatment of these patients. Material and methods. The article present clinical material consisting of all patients rehabilitated for multi-organ injuries in the First Department of Rehabilitation at the Metropolitan Rehabilitation Center in Konstancin, Poland, from 1989-2000. The clinical problems posed by rehabilitation were addressed by a team of specialists, including physicians (mostly orthopedists and rehabilitation specialists), physiotherapists, psychologists, social workers, and a large nursing staff. Results. The article attempts to sum up the results of our efforts, to evaluate our effectiveness, and to challenge some still-existing therapeutic stereotypes in the treatment of these patients. Conclusions. The most effective rehabilitation is early, multi-level, and team-based. An essential role is also played by psychotherapy, social care, and efforts to help the individual rebuild a sense of his/her own value, accept athe handicap, and find a new place in society. Bedside nursing is decisive for the patient's physical and mental comfort, and for the prevention of complications. The restoration of locomotor and self-service skills is the easiest task, while the hardest is recovering full mobility in the distal joints.