Hand and Wrist Treatment

Question 1

Carpel Tunnel Syndrome

Answer 1

Education
- NSAIDS, post ed, keep wrist in neutral, avoid gripping, pinching or strengthening
Splint
- To keep wrist in neutral; 10 days then wean to night use in 6 weeks
Nerve glides
- Median n.

Question 2

Trigger Finger/Thumb

Answer 2

Education
- Avoid full and repetitive composite flexion
Splint 
- Block either MCP or PIP flexion
Active ROM hook fist motion in splint
Passive ROM all joints
Massage tendon/sheath unit

Question 3

DeQuervains

Answer 3

Education
- Avoid sustained and strong grip and pinch and lifting with wrist deviation
Splint
- Thermoplastic with wrist 20 deg extended and thumb abducted
Taping
Pain free AROM
Radial nerve glides

Question 4

Thumb UCL

Answer 4

Education
- Avoid tip-pinch or grasping until 8 weeks following treatment
Splint
- Hand based thumb spica/short opponent
- Exclude IPJ
- Wean splint at 4-6 weeks as pain allows
IPJ ROM exercises

Question 5

Mallet Finger

Answer 5

Splint

- Splint to immobilise DIPJ in slight hyperextension 8-10 weeks while engaging in sporting activity and at night

Question 6

Volar Plate Injury

Answer 6

Education

- Avoid

Question 7

Central Slip

Answer 7

Splint

Question 8

FDP Avulsion

Answer 8

Full tendon strength

Immobilisation, passive and active program

Question 9

Distal Radius Fracture

Answer 9

Spica

Question 10

Scaphoid Fracture

Answer 10

Post-op

Question 11

Hand Fracture

Answer 11

Protect

Question 12

Metacarpal Fracture

Answer 12

ORIF

Question 13

Phalangeal Fracture

Answer 13

Splint

Question 14

Scapholunate Instability

Answer 14

Conservative

Question 15

TFCC

Answer 15

Tape

Question 16

Ulnar Carpal Instability

Answer 16

Strengthening

Question 17

OA CMC

Answer 17

Self management