ROM of Wrist & Hand

Question 1

Patient’s position for:
- Wrist Flexion
- Wrist Extension

Answer 1

• Sitting
• Shoulder & elbow 90 degrees flex
• Hand facing down = over edge of table sufficiently for wrist to move
  (ensure shoulder is neutral, not hitched up or dropped down)

Question 2

Axis of goniometer for:
- Wrist Flexion
- Wrist Extension

Answer 2

Triquetrum

Question 3

Stationary arm for:
- Wrist Flexion
- Wrist Extension

Answer 3

Lateral midline of ulna, aligned from olecranon process to ulnar styloid process

Question 4

Moving arm for:
- Wrist Flexion
- Wrist Extension

Answer 4

Lateral midline of 5th metacarpal

Question 5

Steps for ROM of wrist flexion

Answer 5

1. Have patient sitting on a stable chair with arm on plinth, bent 90 degrees (ensure everything neutral)
2. Position goniometer next to their hand (pinky side)
3. Axis of gonio = Triquetrum; Stationary arm = lateral midline of ulna, aligned from olecranon process to ulna styloid; Moving arm = Lateral midline of 5th metacarpal
4. Ask patient to bend their hand down as much as possible while keeping forearm still
5. Observe for any compensation = movements at elbow joint, shoulder movement
6. Move gonio along with patient’s movement

Question 6

Steps for ROM of wrist extension

Answer 6

1. Have patient sitting on a stable chair with arm plinth, bent 90 degrees (ensure everything neutral)
2. Position goniometer next to their hand (on pinky side)
3. Axis of gonio: Triquetrum; Stationary arm: Lateral midline of ulna, aligned from olecranon process to ulnar styloid process; Moving arm: Lateral midline of 5th metacarpal
4. Ask patient to bend their hand up as much as possible while keeping the forearm still
5. Observe for any compensation = movements of elbow joint, shoulder
6. Move gonio along with patient’s hand

Question 7

Patient’s position for:
- Radial deviation
- Ulnar deviation

Answer 7

Sitting
Shoulder 90 degrees abducted
Elbow 90 degrees flexed
Hand facing down, resting on table

Question 8

Axis of goniometer for:
- Radial deviation
- Ulnar deviation

Answer 8

Capitate

Question 9

Stationary arm for:
- Radial deviation
- Ulnar deviation

Answer 9

Dorsal midline of forearm aligned to lateral epicondyle

Question 10

Moving arm for:
- Radial deviation
- Ulnar deviation

Answer 10

Dorsal midline of 3rd metacarpal

Question 11

Steps for radial deviation

Answer 11

1. Have patient sitting on stable chair with arm (forearm and humerus) on the plinth
2. Position arm at right angle (humerus abducted & forearm at right angle to humerus)
3. Position gonio on top of hand
4. Axis of gonio: capitate; Stationary arm: dorsal midline of forearm aligned to lateral epicondyle; Moving arm: dorsal midline of 3rd metacarpal
5. Ask patient to move their hand inwards toward their body while keeping their forearm still
6. Observe for compensation (pronation of forearm)
7. Move gonio along with patient’s hand

Question 12

Steps in ulnar deviation

Answer 12

1. Have patient sitting on stable chair with arm (forearm and humerus) on the plinth
2. Position arm at right angle (humerus abducted & forearm at right angle to humerus)
3. Position gonio on top of hand
4. Axis: capitate, Stationary arm: Dorsal midline of forearm aligned to lateral epicondyle; moving arm: dorsal midline of 3rd metacarpal
5. Ask patient to move their hand outwards (away from body) while keeping the rest of their body still
6. Observe for compensation (pronation/supination of forearm)
7. Move gonio along with the patient’s hand