hands and UE disorders/injuries

dupuytren’s

• disease of fascia of palm and digits

• flexion deformity

dupuytrens OT intervention

• wound care

• edema control: elevate above heart

• AROM/PROM; progress to strengthening

• scar management

dupuytrens orthosis

hand based extension orthosis (ideally full extension)

skiers thumb (gamekeepers thumb)

• rupture of ulnar collateral ligament of the MCP joint of the thumb

skiers thumb OT intervention

• AROM

• ADLs focusing on opposition and pinch strength

• edema management

• strengthening

skiers thumb orthosis

thumb based orthosis (hand based or forearm based)

complex regional pain syndrome (CRPS)

vasomotor dysfunction as a result of abnormal reflexes

OT interventions for CRPS

• modalities (desensitization, warm fluidotherapy, hot packs)

• edema management

• AROM

• ADLs

• stress loading (weight bearing)

closed reducation

short arm cast, long arm cast, orthosis, sling, fracture brace

colles fracture

fracture of the distal radius with dorsal displacement

smiths fracture

fracture of the distal radius with volar displacement

de quervains

• stenosing tenosynovitis of the thumb

• positive finkelsteins test

de quervains orthosis

thumb spica

lateral epicondylitis (tennis elbow)

degenerative changes of the tendon’s origin as a result of repetitive microtrauma

interventions for tennis elbow

• ice

• stretching

• activity mods

• strengthening

trigger finger

• tenosynovitis of finger flexors caused by repetition

trigger finger interventions

• scar massage

• edema control

• tendon gliding

• activity mods

trigger finger orthosis

hand or finger based orthosis (MCP extended, IP joints free)

carpal tunnel syndrome

• median nerve compression

• positive tinels sign and positive phalens sign

carpal tunnel orthosis

wrist orthosis in neutral (wrist cock up)

carpal tunnel ot treatment

• edema control

• AROM

• scar management

• nerve and tendon gliding

cubital tunnel syndrome

• ulnar nerve compression at elbow

• positive froments sign and tinels sign

• can result in claw hand

cubital tunnel orthosis

elbow orthosis at 30 degree flexion to prevent extreme flexion

cubital tunnel ot treatment

• edema control

• scar management

• AROM and nerve gliding

• strengthening

radial nerve palsy

radial nerve compression

radial nerve orthosis

dynamic wrist and MCP extension orthosis

radial nerve treatment

• AROM

• strengthening

• ADLs

median nerve laceration

• sensory loss

• can be high or low

median nerve laceration splint

• dorsal protection orthosis with wrist positioned in 30 degrees flexion if low

  • include elbow 90 degree flexion If high

radial nerve injury

• sensory loss

• results in wrist drop

radial nerve injury orthosis

wrist cock up

anti-deformity splint

often used for burns