upper extremity Flashcards
Inflammation, soft repair, hard repair, and remodel?
4 phases of bone healing
How long can swelling actually last in fracture patients?
Up to 9 months to a year
ORIF
Open reduction internal fixation
Do not use ointments or soak incisions. Can start ROM at 2-10 days
ORIF care
Avoid dangling, use elevation, compression, ice, and ROM
Edema management
Which 2 ways can PROM be referred to
Passive and passive stretch
Humerus, radial head fracture, wrist fracture, metacarpal fractures and phalanx fractures?
Common upper extremity fractures
Colles fracture or distal radius fracture
Common wrist fracture
Caused by high velocity fall on out stretched hand, most carpal bone fracture
Scaphoid
except humeral fractures and epicondyle fractures, most patients begin AROM within a week after surgery or after cast removal
Treatment
Proximal humeral fractures start with PROM and pendulums
Treatment
Most common with humerus fractures
Frozen shoulder
Freezing, frozen, thawing
3 stages of frozen shoulder
A contracture of the palmar fascia. Which pulls the fingers into flexion
Dupuytrens contractures
A partial laceration, internal/external force (compression),and/or a pull on the arm
Causes of peripheral nerve injuries
Commonly seen in volar surface (digit, palm, wrist)
Peripheral nerve laceration
Safety education for loss of protective sensation. Splint preventing stretch to the repaired nerve and save ROM.
Phase 1 for post op nerve repair
Sensory nerve (desensitization and sensory reeducation). Motor nerve (strengthening in progression)
Phase 2 of post op nerve repair
Compression neuropathy, nerve entrapment, and entrapment neuropathy
Other terms for never compression
Neurapraxia (bruise to the nerve steath), axontomesis (damage to axon fibers),neurotemesis (complete laceration)
Results of compression
Medial nerve (carpal tunnel syndrome), ulnar nerve( elbow), radial nerve
Most common nerve compression
Most common compression neuropathy,. Caused by decreased space in carpal tunnel
CTS
Numbness or tingling in thumb, index, middle, and half of ring finger. Decreased fine motor control, weak or atrophied thenar muscles, decreased pinch strength
CTS symptoms
Neutral wrist split, patient education, tendon gliding exercises
CTS OT treatment
Ulnar nerve kinked around a ligament at the elbow
Cubital nerve compression
Deep tissue and soft tissue massage to supinator and extensors. Ultrasound or electrical stim to extensors. Extensor stretching. Patient education
Radial tunnel treatment
Usually a traction injury
Brachial plexus
Onset after soft tissue or bone injury
Complex regional pain syndrome (CRPS)
Disease of the tendon
Tendonopathy
Tennis elbow
Lateral epicondylitis
Ice, deep friction massage, ultrasound or heat modalities, extensor and supinator stretching, and extensor strengthening
Tennis elbow treatment
Golfers elbow
Medial epicondylitis
Ice, deep friction massage, ultrasound or heart modality, flexor and pronator stretching, and flexor strengthening
Golfer’s elbow treatment
Supraspinatus gets caught under Acromion
Impingement
Rest (tape, support with pillow, avoid above 90 degree elevation). Ice (Supraspinatus tendon). NSAIDS. Ultrasound
Phase 1 of rotator cuff treatment
Isometrics, theraband, postural reeducation
Phase 2 of rotator cuff treatment
PNF diagnosis. Scapular strengthening. Rotator cuff strengthening
Phase 3 of rotator cuff treatment
