UE Orthotics and Hand Function Flashcards

1
Q

what are the goals of hand orthotics

A

prevent deformity
prevent overstretching of muscles
maintain integrity of joints and arches of the hand

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2
Q

reasons why a splint needs to provide functional hand position

A

for natural teneodesis
for maintainence of tendon length
for return of hand function
for anti spasticity

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3
Q

when does the most UE recovery occur

A

in the first 6 months with the greatest rate being in the 1st 3 months of that time

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4
Q

what is the functional position of the hand

A

wrist supported in neutral to 30 degrees of extension
normal transverse and longitudinal arches
finger flexors and extensors are shortened for tenodesis
thumb abducted and in opposition with pads of index and middle finger
preserved web space

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5
Q

spinal cord injury grips

A

tenodesis
lateral pinch
thumb looping (used for pulling up your pants)
interlacing (used for writing or eating)
hypothenar to hypothenar (used for picking up heavier objects)
2 point pinch
incomplete

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6
Q

what do we need to make sure for someone with a C4 and above level of injury

A

positioning of UE to minimize comlications
maintain PROM
address any increased tone
educate family and patient on positioning and PROM
provide wrist supports during the day and resting hand splint at night

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7
Q

when would a resting hand splint be indicated

A

for better positioning at night
when there is weak wrist extension (puts hand in 20-30 ext)
provide stability
prevent deformity

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8
Q

what is the C5 hand known as

A

the “in between” level
continue with interventions with C1-C4 hand and look for any other muscle return
if they have strong elbow flexors position arm to avoid contractures

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9
Q

What type of orthotic could some with a C5 level of injury use and why

A

a wrist cock up splint because it provides wrist ext. with forearm support, maintains the natural arches of the hand while leaving the fingers free and provides more support than a basic wrist orthotic

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10
Q

mechanics of tenodesis

A

active wrist extension that causes finger flexion and thumb approximation
this position is critical for grasping objects

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11
Q

what is the purpose of a short opponens orthotic

A

to pull the thumb into adduction towards the lateral aspect of the index finger

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12
Q

who would benefit from a RIC tenodesis trainer

A

someone with weak C6 just beginning with tenodesis skills
someone with C5 level of injury with weak wrist extension
someone with decreased tightness in long finger flexors

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13
Q

what is the goal of the long opponens splint

A

maintain wrist in neutral extension and thumb and first finger in proper pinch position

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14
Q

who would benefit most from a long opponens splint

A

most effective for patients with a C5 injury

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15
Q

what tendon transfer would restore wrist extension needed for tenodesis and a strong key grip

A

a brachioradialis tendon transfer

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16
Q

what muscle is the most common of the elbow tendon transfers

A

the posterior deltoid; detached and grafted to the elbow to restore elbow extension when the triceps are de-innervated

17
Q

what are the risks of a tendon transfer and joint fusion

A
dependency period
risk of losing function
cost
deformity
infection
18
Q

advantages to splinting

A

low cost
immediate
no dependency period