Term
| Dupuytren's Disease (description, etiology, surgery?, interventions) |
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Definition
| [image]
description: fascia of palm and digits becomes thick and contracted; results in flexion deformities of involved digits
etiology: unknown
surgery?: required
interventions: wound care, whirlpool, dressing changes, night extension splint, A/PROM then strengthening when wounds are healed, scar management |
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Term
| Skier's Thumb (Game Keeper's Thumb) (description, etiology, surgery?, interventions) |
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Definition
| [image]
description: rupture of ulnar collateral ligament of thumb MCP
etiology: (most commonly) fall while skiing with thumb held in a ski pole)
surgery?: most often required
interventions:
conservative treatment (including thumb splint for 4 to 6 weeks)
AROM and pinch strengthening (at 6 weeks)
Focus on ADLs that require opposition and pinch strength
PROM (at 8 weeks post-op)
Strengthening (at 10 weeks post-op) |
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Term
| Complex Regional Pain Syndrome (CRPS) (description, etiology, symptoms, interventions, contraindications) |
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Definition
| * Type I: formerly known as reflex sympathetic dystrophy (RSD) *
** Type II: formerly known as causalgia **
[image]
description: vasomotor dysfunction due to abnormal reflex, can be localized or spread more generally
etiology: may follow trauma or surgery, but actual cause is unknown
symptoms: severe pain, edema, discoloration, osteoporosis, sudomotor changes, temp changes, trophic changes, and vasomotor instability
interventions: modalities to decrease pain, AROM, ADLs to encourage pain-free active use, stress loading, splinting to prevent contractures and enable ability to engage in activities,
contraindications: modalities to avoid = PROM, joint mobilization, dynamic splinting, casting |
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Term
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Definition
Intraarticular vs. extraarticular
Closed vs. open
Dorsal displacement vs. volar displacement
Midshaft vs. neck vs. base
Complete vs. incomplete
Transverse vs. spiral vs. oblique
Comminuted |
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Term
| Medical treatment of fractures |
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Definition
closed reduction: fixed from the outside
types of stabilization include short arm cast (SAC), long arm cast (LAC), splint, sling, or fracture brace
open reduced internal fixation (ORIF): fixed from the inside
types include nails, screws, plates, or wire
external fixation: fixed from the outside with hardware placed under the skin
arthrodesis: fusion
arthroplasty: joint replacement |
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Term
| Colles' fracture (description) |
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Definition
| [image]
fracture of distal radius with dorsal displacement |
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Term
| Smith's fracture (description) |
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Definition
| [image]
fracture of the distal radius with volar displacement |
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Term
| Carpal fractures (most common carpal fractured, caution) |
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Definition
| [image]
most common carpal fractured: scaphoid (60%)
caution: proximal scaphoid has poor blood supply and may become necrotic |
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Term
| Metacarpal fractures (how classified, common complication) |
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Definition
| [image]
classified according to location (head, neck, shaft or base)
common complication of rotational deformities |
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Term
| Proximal phalanx fractures (digits most commonly injured, common complication) |
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Definition
| [image]
digits most commonly injured: thumb and index
common complication: loss of PIP A/PROM |
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Term
| Middle phalanx fractures (common or uncommon) |
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Definition
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Term
| distal phalanx fractures (most common or least common, may result in what orthopedic hand condition) |
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Definition
| [image]
most common finger fracture
may result in Mallet Finger |
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Term
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Definition
| [image]
note: if radial head is involved, there may be limited rotation of the forearm |
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Term
| Humerus fractures (etiology, greater tuberosity vs. humeral shaft) |
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Definition
| [image]
etiology: fall onto an outstretched UE
fracture of greater tuberosity: may result in rotator cuff injuries
fracture of humeral shaft: may cause injury to radial nerve, resulting in wrist drop |
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Term
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Definition
hx
results of special test (Xrays, MRI, CT)
edema
pain
AROM
do not assess PROM or strength until ordered by MD (exception: humerus fractures which often begin with PROM or AAROM)
sensation
roles, occupations, ADLs, activities related to roles |
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Term
| Phases of OT intervention with fractures |
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Definition
immobilization phase: goals of stabilization and healing
mobilization phase: goal is of consolidation |
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Term
| Immobilization phase interventions |
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Definition
AROM of joints above and below stabilized part
edema control: elevation, retrograde massage, and compression garments
light ADLs and role activities with no resistance, progress as tolerated |
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Term
| Mobilization phase interventions |
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Definition
edema control: elevation, retrograde massage, contrast baths, compression garments
AROM: progress to PROM when approved by MD (4 to 8 weeks), exceptions: humerus fractures
light functional/purposeful activity
pain management: positioning and physical modalities
strengthening: begin with isometrics when approved by MD |
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Term
| Cumulative Trauma Disorders (CTD) (aka, risk factors, non-work risk factors, most common types) |
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Definition
aka: repetitive strain injuries (RSI), over-use syndromes, and or/musculoskeletal disorders
risk factors: repetition, static position, awkward postures, forceful exertions, vibration
non-work risk factors: acute trauma, pregnancy, diabetes, arthritis, and wrist size and shape
most common types: DeQuervains, Lateral and medial epicondylitis, trigger finger, nerve compressions |
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Term
| DeQuervains (description, symptoms, diagnosis, conservative treatment, post-op treatment) |
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Definition
| [image]
description: stenosing tenosynovitis of abductor pollicis longus (APL) and extensor pollicis brevis (EPB)
symptoms: pain, swelling over radial styloid
diagnosis: positive Finkelstein's test
conservative treatment: thumb spica splint (IP joint free), activity/work mod, ice massage over radial wrist, gentle AROM of wrist and thumb to prevent stiffness
post-op treatment: thumb spica splint and gentle AROM (0 to 2 weeks), strengthening, ADLs, and role activities (2 to 6 weeks), unrestricted activity (6 weeks) |
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Term
| Lateral epicondylitis (aka, description, etiology, conservative treatment) |
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Definition
| [image]
aka: Tennis elbow
description: degeneration of the tendon origin as a result of repetitive microtrauma
etiology: overuse of wrist extensors, especially the extensor carpi radialis brevis (CRB)
conservative treatment: elbow strap, wrist splint, ice and deep friction massage, stretching, activity/work mod, as pain decreases, begin strengthening |
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Term
| Medial epicondylitis (aka, description, etiology, conservative treatment) |
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Definition
| [image]
aka: Golfer's elbow
description: degeneration of the tendon origin as a result of repetitive microtrauma
etiology: overuse of wrist flexors
conservative treatment: elbow strap, wrist splint, ice and deep friction massage, stretching, activity/work mod, as pain decreases, begin strengthening |
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Term
| Trigger finger (description, etiology, conservative treatment) |
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Definition
| [image]
description: tenosynovitis of the finger flexors: commonly the A1 pulley
etiology: repetition and the use of tools that are placed too far apart
conservative treatment: scar massage, edema control, tendon gliding, activity/work modification |
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Term
| Rotator Cuff Tendonitis (etiology, conservative interventions, surgical interventions, post-op interventions) |
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Definition
| [image]
etiology: repetitive overuse, curved or hook acromion, weakness of rotator cuff,w eakness of scapula musculature, ligament and capsule tightness, trauma
conservative interventions: activity mod (avoid above shoulder level activities until pain subsides), educate in sleeping posture (avoid sleeping with arm overhead or combined ADductiona nd internal rotation), decrease pain (positioning, modalities, and rest), restore pain free ROM, strengthening (below shoulder level), occupation and role specific training
surgical interventions: athroscopic surgery, open repair (small, medium, large, and massive tears)
post-op interventions: PROM (0 to 6 weeks -- progressing to AA/AROM), decrease pain (begin with ice, progress to heat), strengthening (6 weeks post-op -- begin isometrics, progress to isotonic below shoulder level), activity mod, leisure and work activities (8 to 12 weeks post-op) |
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Term
| Adhesive Capsulitis (aka, symptoms, etiology, conservative interventions, surgical interventions, post-op interventions) |
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Definition
| [image]
aka: frozen shoulder
symptoms: restricted PROM (particularly external rotation, then ABduction, internal rotation, and flexion)
etiology: inflammation and immobility, linked to diabetes mellitus and Parkinsons disease
conservative interventions: encourage active use through ADLs and role activities, PROM, modalities
surgical interventions: manipulation and arthroscopic surgery
post-op interventions: PROM immediately follwoing surgery, pain relief (modalities), encourage sue of extremity for all ADLs and role activities |
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Term
| Shoulder Dislocations (most common type, etiology, interventions) |
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Definition
| [image]
most common type: anterior dislocation
etiology: trauma, repetitive overuse
interventions: regain ROM (avoid combined ABduction and external rotation with anterior dislocation), pain free ADLs and role activities, strengthen rotator cuff |
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