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Rehab Tutorial Wrist and Hand

This document provides guidance on managing ligament sprains of the wrist and hand. Key points include: 1. Common mechanisms of injury are falling on an outstretched hand and injuries occurring in athletes, with the radial ligament most often affected. Aggravating factors include movements that put pressure on the wrist. 2. Red flags to assess for include fractures, osteoarthritis, rheumatoid arthritis, and gout. 3. Grading scales, imaging like MRI and arthroscopy, and tests like the TFCC stress test should be used in evaluation. 4. Initial treatment focuses on immobilization, ice, compression, and elevation. Later phases emphasize gentle mobility and strength exercises as pain sub

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74 views2 pages

Rehab Tutorial Wrist and Hand

This document provides guidance on managing ligament sprains of the wrist and hand. Key points include: 1. Common mechanisms of injury are falling on an outstretched hand and injuries occurring in athletes, with the radial ligament most often affected. Aggravating factors include movements that put pressure on the wrist. 2. Red flags to assess for include fractures, osteoarthritis, rheumatoid arthritis, and gout. 3. Grading scales, imaging like MRI and arthroscopy, and tests like the TFCC stress test should be used in evaluation. 4. Initial treatment focuses on immobilization, ice, compression, and elevation. Later phases emphasize gentle mobility and strength exercises as pain sub

Uploaded by

api-451168851
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Tutorial for rehabilitation of peripheral joints

Wrist and Hand presentations

Group 7. No images

Ligament sprains of the wrist hand

The following questions should be answered

1. What is a classic history or capsule summary for this presentation? Specifically a typical
mechanism of injury and the typical aggravating and relieving factors.

Foosh, landing on the thenar in extension.


Common in athletes and radial is the most common side.
Aggravating factors are anything that puts pressure on the wrist.
Relieving factors are stabilising the joint.

2. What red flags and other conditions you need to eliminate? (include systemic and peripheral
presentations.

Scaphoid fracture, OA, RA and Gout.

3. What outcome assessments would you use?

DASH
VAS
ROM
Grip Strength

4. If there is a grading scale, can you briefly describe it?

1 – pain with minor damage to ligament


2 – Pain with more significant ligament damage, looseness and a loss of joint function
3 – complete tear, looseness and a loss of joint function

5. What imaging techniques would you use and why?

MRI – so we can view soft tissue and inflammation


Arthroscopy – to physically view
Arthrogram – to better view damage ligaments

6. On the provided Images, please indicate the pathology and describe it?

None given
7. What relevant orthopaedic, quantitative and qualitative tests would you use? Demonstrate
one of each on the patient to the class.

TFCC stress test &


Scaphoid Watson shift test
Bracelet test
Stress tests of all Carpal ligaments and distal radioulnar ligament

8. Outline your management strategy including chiropractic and other techniques, treatment
plan; including your visit schedule, home advice, exercises and progressions. Include
expectations of what they can achieve at relevant time frames and what exercises you would
use in the relevant time frames.

When acute the joint needs to be rested and made immobile. Ice may be applied in the
acute stage. From there depending on the grade of the ligament sprain compression heat
and elevation may be applied.
If a grade 3 tear is identified surgery will be required.

In the second phase of rehab after swelling has subsided mobility is important and should be
started as soon as possible. When pain dissipates gentle strength exercises may be
implemented that include flexion, extension, ulnar and radial deviation.

Although evidence is limited alternative therapies such as shock wave therapy, TENS and
ultrasound may be considered.

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