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Upper Extremity
| Question | Answer |
|---|---|
| OT treatment: ROM, once medically cleared, casting/thermoplastic splint with hand in palmar flexion | Colles fracture |
| Thickening and shrinking of the fascia of the palm with fingers being drawn into a flexed position | Dupuytren's contracture |
| OT treatment: PROM to prevent contractures, resting hand splint | Flaccidity |
| Damage to the median nerve; deformity in which people cannot move thumb away from rest of hand. - All digits become aligned in the same dorsal-ventral plane due to paralysis of the thenar muscles | ape hand |
| a paralysis of the arm that most often occurs as an infant's head and neck are pulled toward the side at the same time as the shoulders pass through the birth canal - Atrophy and paralysis | Erb's Palsy |
| inflammation of the thumb muscles/tendon unit - Pain - swelling - limited motion in the abductor pollicis longus | De Quervain's Tenosynovitis |
| OT treatment: forearm based thumb spica splint, grip and pinch strengthening, scar management, splint with wrist in 20 degrees extension | De Quervain's Tenosynovitis |
| Inflammation and thickening of the tendons of the finger makes it difficult to flex or extend the finger, may become stuck and then snap into position - edema in the tendon and synovium of the digit | Trigger Finger |
| OT treatment: hand based TF splint (MCP/DIP/PIP free), edema control, tendon gliding, work modification, blocking splint to protect the released tendon while it is healing contrainidications: no active strengthening of the flexor tendons, | Trigger Finger |
| inflammation of the tendons of the wrist - pain | Wrist Tendonitis |
| OT treatment: AROM, joint protection, wrist forearm splint Contraindications: no forceful grip, no using affected hand to carry heavy objects | Wrist Tendonitis |
| fragment of bone chipped away from the main bone | avulsion fracture |
| OT treatment: Icing the affected area, cantrolled range of motion, scar management at surgical site | avulsion fracture |
| affected finger is unable to extend and rests in flexion | extensor tendon injury |
| OT treatment: tendon gliding exercises, heat modalities, NMES contraindication: over use of the tendon too early after surgery can result in rupture of the tendon | extensor tendon injury |
| affected finger is unable to flex and rests in extension - impossible to bend the fingers or thumb | flexor tendon injury |
| OT treatment: flexor tendon protocal Contraindication: over use of the tendon too early after surgery can result in rupture of the tendon | flexor tendon injury |
| avulsion of the terminal tendon | Mallet Finger |
| OT treatement: splint the clients DIP joint in full extension | Mallet Finger |
| flexion of PIP joint and hyperextension of DIP joint | Boutonniere deformity |
| OT treatment: PIP is splinted in extension | Boutonniere deformity |
| OT treatment: heat modalities, AROM, joint protection, hand thumb spica splint | CMC arthritis |
| inflammatory disorder that may affect many tissues and organs | rheumatoid arthritis |
| hyperextension of PIP and flexion of DIP | Swan neck deformity |
| OT treatment: joint protection, PIP splint in slight flexion, buttonhole splint | Swan neck deformity |
| Ulnar deviation of the fingers at the MCP joints | Ulnar drift |
| OT treatment: PROM, modalities, encourage active use, pain management, dynamic shoulder splint | Adhesive Capsulitis |
| loss of muscle tone, no active movement present | Flaccidity |
| high median nerve injury, only occurs when attempt made to make a fist | Hand of Benediction |
| OT treatment: C-bar splint with thumb in opposition, gentle AROM, tendon gliding, scar management, splinting per protocol, PROM only after 2 months post surgery. Contraindication: No PROM or strengthening until authorized by physician | Ape hand deformity |
| Happens when these nerves are stretched, squeezed together, or in the most serious cases, ripped apart or torn away from the spinal cord. - Pain including avulsion pain - Loss of sensation - Partial or total paralysis of affected upper extremity | Brachial Plexus Injury |
| OT treatment: PROM, AROM, sensation retraining, flail arm splint, edema control | Brachial Plexus Injury |
| Spinal cord is partially or completely severed at the level of the 5th cervical vertebra - Movements possible: shoulder flexion, abduction, extension, elbow flexion, supination, scapular adduction, abduction | C5 spinal cord injury |
| OT treatment: AROM, PROM, splinting of hands, wrist cock-up splint with universal cuff Contraindication: Monitor for muscle tightness and spasticity | C5 spinal cord injury |
| Partially or completely severed spinal cord at the level of 6th or 7th cervical vertebrae | C6-C7 Spinal Cord Injury (SCI) |
| OT treatment: tenodesis splint | C6-C7 Spinal Cord Injury (SCI) |
| OT treatment: elbow lock splint | Erb's Palsy |
| trauma to the median nerve - Causes ape hand deformity - sensory loss - loss of pinch | Median nerve injury |
| OT treatment: Static thenar web spacer splint, AROM, PROM, tendon gliding, scar management, dorsal wrist blocking splint with wrist in 30 degrees of flexion | Median nerve injury |
| trauma to ulnar nerve | Ulnar nerve injury |
| OT treatment: ulnar nerve injury splint, dynamic/static splint to position MP's in flexion, orthotics used for immobilization, dorsal protection splint with wrist in 30 degrees of flexion | Ulnar nerve injury |
| inflammation of elbow muscles, tennis elbow - limited movement of the wrist extensors | lateral epicondylitis |
| OT treatment: lateral epicondylitis brace | lateral epicondylitis |
| inflammation of the tendons of the wrist flexors, golfers elbow - pain - inflammation - limited movement of the wrist flexors | Medial epicondylitis |
| OT treatment: Medial epicondylitis brace, elbow immobilizer 1-3 weeks post surgery, strengthening of flexor and pronator muscles 6 weeks post op | Medial epicondylitis |
| Inflammation of the tendons of the shoulder that attach to the muscles that make up the rotator cuff. - pain - swelling | Rotator cuff tendonitis |
| OT treatment: Activity modification, pain management, shoulder support sling, shoulder immobilizer, AROM and strengthening 6 weeks post op | Rotator cuff tendonitis |
| Most commonly involved arthritic joint in the hand. | CMC arthritis |
| OT treatment: edema control, AROM, joint protection, volar wrist cock -up in extension up to 30 degrees, ulnar drift splint | rheumatoid arthritis |
| OT treatment: joint protection, work simplification, ulnar deviation splint | Ulnar drift |
| Fracture at base of first metacarpal | Bennett's fracture |
| most commonly seen in the 4th and 5th digits | Boxer's fracture |
| OT treatment: strengthening when fracture has healed, ulnar gutters splint | Boxer's fracture |
| Characterized by an overactive sympathetic nervous system, uncommon and its cause isn't clearly understood - pain - swelling - stiffness | Complex Regional Pain Syndrome (CRPS) |
| OT treatment: TENS, splinting, edema control, tendon gliding, static volar splint in extension | Complex Regional Pain Syndrome (CRPS) |
| Complete fracture of the distal radius with dorsal displacement (extension of the wrist) | Colles fracture |
| Complete fracture of the distal radius with palmar displacement (flexion of the wrist joint) | Smith's fracture |
| OT treatment: wrist/ forearm splint | Smith's fracture |
| Loss of range of motion in the shoulder; also called frozen shoulder | Adhesive Capsulitis |
| OT treatment: edema control, AROM, PROM, scar management, extension splint | Dupuytren's contracture |
| Lacking firmness, resilience, or muscle tone in the wrist | Flaccid Wrist |
| OT treatment: Support users wrist in 10 to 20 degrees of extension, wrist cock up splint | Flaccid Wrist |
| Involuntary muscle contractions of the hand | Focal hand dystonia |
| OT treatment: adaptations, compensatory strategies, mirror therapy | Focal hand dystonia |
| Increased muscle tone | Spasticity |
| OT treatment: AROM, PROM, home exercise, anti-spasticity splint,cone | Spasticity |
| Permanent fixed position of the hand at rest - ulnar nerve - 4th and 5th fingers hyperextended at MCP joints and hyperflexed at the IP joint | Ulnar claw hand |
| OT treatment: orthotics used for immobilization, ROM after medically cleared, thumb spica splint Contraindications: watch for instability of the joint | Bennett's fracture |
| Most common injury to the wrist | Carpal fractures |
| OT treatment: edema control, AROM, wrist cock-up with thumb spica splint | Carpal fractures |
| A type of vasculitis that causes blood vessels to narrow, reducing blood flow to the extremities | Raynaud's disease, |
Created by:
cnk
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