OTHY206 Hand and Upper Limb Rehabilitation Summaries Week 2 ...
OTHY206 Hand and Upper Limb Rehabilitation Summaries Week 2 Summary 1. Swan neck deformityflexure contracture of the MCP joint, compensatory hyperextension of the PIP joint and flexion of the DIP joint, caused by contractures of the interosseous and flexor muscles and tendons
2. Boutonniere deformitycombination of PIP joint flexion and DIP joint hyperextension, caused by rheumatoid arthritis
3. Intrinsic tightnesstightness of the intrinsic muscles of the hand, caused by muscle imbalance between spastic intrinsics (interosseoi and lumbricals) and weak intrinsics (flexor digitorum profundus and superficialis and extensor digitorum), tested by Bunnel test which is performed by passively holding the MCP joints extended & either actively or passively flexing PIP joint 4. Extrinsic extensor tightnessPIP and DIP flexion is limited when wrist (MCP joint) is passively flexed, caused by burn or trauma which results in a prolonged period of extensive positioning from a cast, tested by making a fist with wrist in flexion 5. Extrinsic flexor tightnesscaused by burn or trauma which results in a prolonged period of flexion positioning from a cast, tested by extending the wrist and maintaining a closed fist 6. Anatomical considerationsarches of hand, bony prominences, convergence to scaphoid, dual obliquity, skin creases 7. Mechanicmechanical advantage, ensure three points of pressure, contour to increase strength, high vs low profile, angle of pull, ninety degrees, increase surface area, consider safe forces 8. Splint purposesimmobilisation, mobilisation, restriction, torque transmission 9. Position of restwrist at 10-20 degrees of extension, finger MCP joint at 20-30 degrees of flexion, finger PIP joint at 0-20 degrees of flexion, finger DIP joint at 5 degrees of flexion, thumb extended and abducted at CMC joint with 5 degrees of flexion at MCP and IP joints 10. Position of safe mobilisationfinger PIP and DIP at 0 degrees, finger MCP joint at 10-90 degrees of flexion, thumb extended and abducted, wrist at 20-30 degrees of extension
2. Boutonniere deformitycombination of PIP joint flexion and DIP joint hyperextension, caused by rheumatoid arthritis
3. Intrinsic tightnesstightness of the intrinsic muscles of the hand, caused by muscle imbalance between spastic intrinsics (interosseoi and lumbricals) and weak intrinsics (flexor digitorum profundus and superficialis and extensor digitorum), tested by Bunnel test which is performed by passively holding the MCP joints extended & either actively or passively flexing PIP joint 4. Extrinsic extensor tightnessPIP and DIP flexion is limited when wrist (MCP joint) is passively flexed, caused by burn or trauma which results in a prolonged period of extensive positioning from a cast, tested by making a fist with wrist in flexion 5. Extrinsic flexor tightnesscaused by burn or trauma which results in a prolonged period of flexion positioning from a cast, tested by extending the wrist and maintaining a closed fist 6. Anatomical considerationsarches of hand, bony prominences, convergence to scaphoid, dual obliquity, skin creases 7. Mechanicmechanical advantage, ensure three points of pressure, contour to increase strength, high vs low profile, angle of pull, ninety degrees, increase surface area, consider safe forces 8. Splint purposesimmobilisation, mobilisation, restriction, torque transmission 9. Position of restwrist at 10-20 degrees of extension, finger MCP joint at 20-30 degrees of flexion, finger PIP joint at 0-20 degrees of flexion, finger DIP joint at 5 degrees of flexion, thumb extended and abducted at CMC joint with 5 degrees of flexion at MCP and IP joints 10. Position of safe mobilisationfinger PIP and DIP at 0 degrees, finger MCP joint at 10-90 degrees of flexion, thumb extended and abducted, wrist at 20-30 degrees of extension
