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Wrist and Hand - Coggle Diagram
Wrist and Hand
Deformity
Claw hand
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Sign: hyperextension of 4th, 5th MCP and hyperflexion of PIP, DIP
Risk factor: age, occupation, trauma, diabetes...
Management: splinting, surgery
PT intervention: mobilization, stretching, functional training
Drop hand
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Sign: can't wrist extension, finger extension...
Management: medication, splinting, surgery...
PT intervention: modalities, ROM exercise, mobilization...
Monkey/ Ape hand
Mechanism: median n. injury cause thenar muscle paralyzed, the thumb is then pulled to the same level of other phalanges
Sign: same level of all fingers, loss of thenar muscle
Risk factor: repetitive use of hand, trauma, inflammation
Managament: anti-inflammatory medication, surgery, splinting
PT intervention: thumb strengthening, stretching, mobilization, sensory retraining...
Swan neck
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Management: splinting, surgery
PT intervention: stretching, ROM, strengthening
Boutonniere Deformity
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Sign: flexion contracture on PIPJ, while hyperextension of DIPJ
Risk factors: RA, trauma, burn
Management: splinting, surgery
PT intervention: modalities, ROM, strengthening, stretching
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Sign: pain, stiff, or catching when going through the pulley (MCP flexion and extension). Especially in the morning.
Risk factors: age, women, diabetes
Management: rest, analgesia, splinting, steroid, surgery
PT intervention: modalities, joint mobilization, ROM maintainence
Examination
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Observation
wounds, scar, edema, hematoma, nail changes...
skin color, temp, trophism, gooseflesh...
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Special tests
Aim: to rule out SL lig. tear, but low confident to confirm SL lig. tear
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Principle: scaphoid moves to palmar side due to SL lig. when radial deviation occurs, without SL lig. the scaphoid is pushed to dorsal side, and slide back when examiner release his pushing force
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Aim: to check if there is Distal Radial Ulnar Instability, or TFCC injury
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Observe: tingling of thumb, index, middle, lateral half of ring finger
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