Chapter 15 The Wrist, Hand, and Fingers

1
Chapter 15 The Wrist, Hand, and Fingers

• Pages 552-555

2
QUIZ

• Question 1
• Which active and passive motions may be limited
  due to a TFCC injury?
• Question 2
• Describe the SPECIFIC areas of decreased
  sensation due to Carpal Tunnel Syndrome.
• Question 3
• List three (3) other S S of CTS.

3
Wrist Sprains

• Mechanism of injury for many wrist pathologies
  may be similar
• Must rule out all possible injuries
• Evaluative Findings
• Table 15-5, page 553

4
Triangular Fibrocartilage Complex Injury

• Trauma may result in permanent disability if left
  untreated
• Athletes closed kinetic chain sports
• Greater risk of TFCC injury
• Must differentiate from UCL sprain
• Evaluative Findings
• Table 15-6, page 554

5
Carpal Tunnel Syndrome

• Compression of median nerve as it passes through
  carpal tunnel (Fig. 15-8, page 528)
• May occur due to
• Repetitive microtrauma
• Acute trauma
• Result of progressive degeneration of structures
  within tunnel
• May have effect on athletics and ADLs

6
Carpal Tunnel Syndrome

• Signs and Symptoms
• Paresthesia and pain along median nerve
  distribution
• Often occurs at night due to impeded venous
  return
• Atrophy of thenar muscles
• Decreased grip strength
• Achy pain on volar aspect of forearm

7
Carpal Tunnel Syndrome

• Evaluative Findings
• Table 15-7, page 554
• Tinels Sign
• Figure 15-25, page 553
• Phalens Test for Carpal Tunnel Syndrome
• Box 15-13, page 555

8
Carpal Tunnel Syndrome

• CTS closely resembles symptoms of impingement of
  C7 nerve root and proximal neuropathy of median
  nerve
• Conservative Treatment
• Rest
• Modification of activities, posture, work
  stations
• NSAIDs
• Splinting

9
Carpal Tunnel Syndrome

• Surgical Treatment
• Relieve compression on median nerve
• Initial period of NSAIDs and immobilization
  post-op, followed by AROM and strengthening

10
Wrist Fractures

• Colles Fracture
• Fracture of radius approximately 1.5 inches
  proximal to radiocarpal joint distal radius
  displaced dorsally
• Often used to describe any distal radius fracture
• Figure 15-26, page 556

11
Wrist Fractures

• Smiths Fracture
• Also called reverse Colles fracture
• Distal radius fracture that is displaced palmarly
• Evaluative Findings
• Table 15-8, page 556