Please enable JavaScript.
Coggle requires JavaScript to display documents.
NGP Wrist/Hand - Coggle Diagram
NGP Wrist/Hand
Videos
Wrist AROM - how to measure accurate range (use pencil)
Finger AROM
Stress Tests - Scaphoid, Du Quervain's, finger collaterals/valgus tests
Swelling - measure using piece of string
Joint Palpation - DRUJ AP/PA, Carpal Rows prox vs distal row, individual carpal joints, 1st CMCJ
Taping - thumb taping, finger, wrist
Stretches - wrist ext, wrist flex, sup/pronation, finger flex, finger ext
Exercises - retrain normal mvt (e.g. lifting kettle, gripping, push-ups), wrist isometrics, isotonics, finger strength (elastic band, self-resisted)
Get rid of swelling with piece of string
Mobilisations - follow on from Ax
Common Injuries
TFCC Sprain - MOI, goal of rehab, treatment
Distal Radius fracture - MOI, prognosis, goal of rehab, treatment
Carpal Tunnel Syndrome - MOI, symptoms, how to diagnose, quick summary of management, wrist brace into flexion, unload neural tissue, ?? pregnancy link, then refer to other presentations
Scaphoid Fracture - MOI, symptoms, prognosis, treatment plan
Finger Fracture - MOI, suspect until x-ray'd, treatment
Thumb OA - MOI, demographic, pain type, treatment plan
Mallet Finger/Swan Neck Deformity - MOI, management
Finger collateral ligament/dislocation - MOI, pain location, swelling, management
Du Quervain's - MOI, diagnosis, treatment
Physical Exam
Observation - swelling, colour changes, deformity, mm wasting
AROM - wrist (F, E, ulnar/rad dev, pron/sup), finger (F, E, 1 joint vs all joints)
PROM - overpressure, care with traumatic injuries
Stress tests - finger collaterals, Du Quervain's test, Scaphoid fracture squeeze/grip test
Palpation - snuff box, TFCC, finger joint line
Grip strength - pressure cuff, dyno
Function - WB, Aggs, lifting, push-ups
Swelling - measure with piece of string/ribbon
Joint Palpation - scaphoid/lunate, distal vs proximal carpal rows, DRUJ, 1st CMCJ
Management
Swelling - Compress, protect
Scans - x-ray, scaphoid protocol
Restrict ROM - sprain - taping, bracing, isometrics, splint (mention but don't demo - refer on if don't use at your clinic), modify Aggs (lift with 2 hands rather than 1 hand etc)
Increase ROM - massage, mobilisations, stretches (only if indicated, depends on pathology & non-provocative)
Taping - thumb, wrist, finger (hyperextension taping rather than buddy taping)
Exercises - Retrain normal wrist mvt (Du Quervain's), wrist isometrics & isotonic, grip strengthening, WB progressions
Stretches - finger ROM, wrist ROM (post-fracture)
Subjective
Location of Pain, P&N, numbness, weakness
MOI - FOOSH, gradual onset, traumatic
Night Pain - fracture, swelling
Agg/Ease Factors - WB vs NWB, grip/squeeze, carry, lifting, bending finger, repetitive tasks (computer, mousework)
Med Hx - diabetes, osteoporosis, pregnancy, OA
Anatomy
Wrist - bones, ligaments, nerves
Hand - nerves
Fingers - bones, ligaments, muscles