Rehab of injuries to the wrist and hand power pt
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Rehab of injuries to the wrist and hand power pt
- 1. Wrist and Hand injuries
- 2. Bones most often injured • Radius • Ulna • Lunate (dislocation) • Scaphoid (fracture in anatomical snuffbox) • Metacarpals • Phalanges
- 3. Wrist Injuries • Colle’s Fracture • Sprain • Tendonitis • Ganglion cyst
- 4. Hand injuries • Dislocation of lunate • Scaphoid Fracture • Hamate Fracture • Metacarpal Fracture—Boxer’s fracture
- 5. Colle’s Fracture • Involves the distal end of radius Silver fork deformity
- 6. Cont… MXN: • Fall on an outstretched hand • Run into wall, etc, with wrist hyper extended S/S: • Visible deformity —”silver fork” • Swelling • Pain • Pot
- 7. RX: • Splint in position you find it • Ice • ER • 1-2 month recovery time
- 8. Wrist Sprain Mxn: – Abnormal forced movement of the wrist – Falling on hyper extended or hyper flexed wrist – Violent torsion
- 9. Cont… S/S: • Pain • Point tenderness • Swelling • Difficulty moving wrist—limited ROM • TX: • RICE for mild/ moderate • Physician referral to rule out fx for severe • Splint if necessary • Exercises for strengthening and ROM • Tape for support
- 10. Cont…
- 11. Dislocation of Lunate Mechanism: • Forced hyperextension of wrist S/S: • Pain • Swelling • Difficulty moving wrist and fingers into flexion • Numbness/paralysis of flexors due to pressure of lunate on median nerve • deformity
- 13. Ctd… RX: • Splint • Ice • Physician referral for reduction • 1-2 month recovery time
- 14. Scaphoid Fracture Mechanism: • Fall on hyperextended wrist • Force on outstretched hand (hyperextended wrist) that compresses the bone between the radius and 2nd row of carpal bones
- 15. Ctd… • S/S: • Pain and pot over the anatomical snuffbox • Swelling • Possible discoloration • ROM limitation
- 17. Ctd… RX: • Ice • Splint • Physician referral • Initial immobilization for 6 weeks • If not recognized as fracture, could have non-union then surgery is required
- 18. Hamate Fracture Mechanism: • Fall on hand • Contact to palm of hand with sports implement
- 19. Cont…
- 20. Ctd… S/S: • Wrist pain • Weakness in wrist motion • Pot over hook of hamate • Possible tingling, numbness due to compromise of ulnar nerve TX: • Ice • Splint • Physician referral • cast
- 21. Metacarpal (Boxer’s) Fracture • Most common of all metacarpal fractures • Associated with martial arts/boxing Mechanism: • direct axial force caused by punching another person or object • Direct impact to hand
- 22. Cont… S/S: • Pot over the metacarpal involved • Palpable defect in the shaft of the 5th metacarpal (or other metacarpals) • Swelling • Discloration • Pain with movement
- 23. Cont… RX: • Ice • Splint • Physician referral for x-ray • Reduction and casting (3-4 weeks)