9] Wrist Flashcards
Dinner fork deformity
Colles’ fracture
Retrograde massage Edema glove Compression sleeve Elevation AROM Taping
Edema management
PROM intervention for wrist
Prayer stretch Thinker stretch Table stretch Ball rolling Ball turns
OP for distal radioulnar
10 deg supination
CP for distal radioulnar
5 deg supination
Radio/ulnar carpal joint is more responsible for
Extension
Midcarpal joint is more responsible for ?
Flexion
OP for radio/ulnar carpal
Neutral
Slight UD
CP for radio/ulnar carpal
Full extension and radial deviation
Midcarpal joint OP
Neutral, slight flex, slight UD
Midcarpal joint CP
Full extension
Functional ROM for wrist flexion
5-40 deg
Functional ROM for wrist extension
30-40 deg
Functional ROM for wrist RD
10-20 deg
Functional ROM for wrist UD?
15-20 deg
Radial styloid Scaphoid Scaphotrapezial joint and trapezium Base of 1st MC 1st CMC joint Tendons of 1st-3rd extensor compartments Dorsal radial sensory nerve (DRSN)
Radial dorsal zone
Listers tubercle Lunate Scapholunate interval Capitate Base of 2nd and 3rd MC Tendons of 2nd-4th extensor compartments
Central dorsal zone
Ulnar styloid Ulnar head DRUJ TFCC Hamate Triquetrum Lunotriquetral interval 4th and 5th CMC ECU
Ulnar dorsal zone
Scaphoid tuberosity Palmaris longus FCR Median nerve Radial artery
Radio volar zone
Pisiform
Hook of hamate
FCU
Ulnar nerve and artery
Ulnar volar zone
Edema control Digital ROM Pain control Modalities Education AROM exercise Joint mobs
4 weeks post op
Continue with current POC Progress to PROM of wrist and forearm Scar massage/mob Wrist isometrics Dexterity
6 weeks post op
Wrist strength
Grip and pinch strength
Progress ROM to WFL
8 weeks post op
Progress to full WB
Progress to return to sport
Teach an independent HEP
12-16 weeks post op
Fracture of wrist
Scaphoid fracture
Entrapment of wrist syndromes
Carpal tunnel and ulnar tunnel
Instability of the wrist
TFCC
Scapholunate instability
DRUJ instability
Scaphoid fracture MOI
FOOSH
Pain/tenderness in anatomic snuff box
Swelling and bruising possible
Signs and Sx of scaphoid Fx
Tenosynovitis Joint dislocation Fx Arthritis Fluid build up during pregnancy
MOI for carpal tunnel
Night pain Numbness Tingling Weak grip Occasional clumsiness Tendency to drop things Thenar atrophy (late stage)
Signs and Sx of carpal tunnel
Rest, splinting
Decrease pain and inflammation
Tendon and nerve glide
Education
Acute goals for carpal tunnel release
Stretching
Desensitization
Strength and endurance
Coordination
Sub acute goals for carpal tunnel release
Cyst FOOSH Cycling Repetitive trauma Chronic pressure
MOI for ulnar tunnel syndrome
Weakness
Pain
Numb/tingle
Signs and Sx for ulnar tunnel syndrome
Fall onto supinated outstretched hand
MOi for TFCC
Direct blow to the ulnar side of wrist/hand
MOI for TFCC
Swinging a bat or racquet
Violent twist of the wrist at work or in sports
Associated with DRF
MOI for TFCC
Pain on ulnar side of wrist
Increased with end range pronation, supination and forceful griping
Clicking or feeling of catch in wrist
Weakness
Signs and Sx for TFCC
Press (sit to stand) test
Supination lift test
TFCC load test
TFCC tear
Most common carpal instability
Scapholunate instability
FOOSH
Arthritis
MOI for scapholunate injury
Pain
Weak grip strength
Swelling
Inability to weight bear
Signs and Sx of scapholunate injury
Watsin test
Scapholunate injury
Inhibit what muscle for scapholunate Tx?
ECU
After DRF
FOOSH
Arthritis
MOI for DRUJ
Dorsal wrist pain
Limited pronation/supination
Decreased grip strength
“Clunk” with UD
Signs and Sx of DRUJ
Radioulnar ballottement
Piano key
Special tests for DRUJ
