Wrist and Hand Flashcards
Contents of Carpal Tunnel
- 9 tendons, one nerve
- median nerve
- FDP, FDS, FPL
Carpal Tunnel Movement Impairment
-gripping/prehension using finger flexors with wrist flexed
Pressure on Median N caused by__________ in carpal tunnel
- finger extension with wrist flexed
- ant movement of tendons decrease distance between finger flexor tendons and retinaculum/transverse carpal ligament
CTS
-Carpal Tunnel Syndrome
CTS Treatment:
Stage I: local
- Injection
- Acupuncture
- Massage
- Active Release
- Bracing
- Tendon Glides (2 min/hour)
- Surgery (endoscopic release carpal tunnel syndrome)
CTS Bracing
- effective
- neutral wrist and neutral MCP
CTS Treatment:
Stage II: Adjacent
- Shoulder strength
- CS
- Neurodynamics
- Movement Impairment–neutral wrist
CTS Treatment:
Stage III: global
- work-related items, (take breaks, splints at night)
- prevention (posture)
CTS Prevention
- avoid smoking
- mntn appropriate weight
- modify workstations, keyboards, tools
- treat wrist arthritis
Beighton’s Scale of Hypermobility
- 9 points of hypermobility
- 6/9 for diagnosis for hyperflexibility
- thumbs (2)
- pinky fingers (2)
- elbows (2)
- knees (2)
- hips (1)
DASH
- disabilits of the arm, shoulder & hand
- 30 items divided between work etc tasks
- 0%=no limitations
Thumb Hypermobility Treatment
-Stage I: Local
- strengthen EPB, APB (rubberband resistance)
- edu to mntn arch of thumb for functional activity
- splint to stabilize MCP joints
-correct alignment, protection, activity modification
Colles’ fracture
- FOOSH
- distal radial/ulnar fracture with dorsal dysplacement
- dinner deformity (fork tines down)
Post Fracture Concerns
- osteoporosis
- osteopenia
- CRPS
Hypermobile Thumb:
Movement Impairment Example
-thumb MP flexion with CMC accessory hypermobility
