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UE Injuries * OT
NBCOT exam
| Question | Answer |
|---|---|
| Dupuytren's Disease | Fascia of the palm & digits become thick & contracted-->flexion deformities. |
| Dupuytren's Disease: OT Intervention | Wound care: Dressing changes; whirlpool if infection is suspected.Edema control: Elevation above the heart.A/PROM,& progress to strengthening.Scar management (massage, scar pad,comp gar)Functional:Emphasize flexion (gripping) & extension (release) |
| Dupuytren's Disease: Splint | Extension Splint: Initially at all times except to remove for ROM and bathing. |
| Skier's Thumb (Gamekeeper's Thumb) | Rupture of the ulnar collateral ligament of the MCP joint of the thumb. |
| Skier's Thumb: OT Intervention | AROM & pinch strengthening (@6 weeks); Focus on ADL that require opposition & pinch strength; Post operative: thumb splint for 6 weeks, followed by AROM; PROM can begin @ 8 weeks & strengthening @ 10 weeks. |
| Skier's Thumb: Splint | Conservative treatment including thumb splint for 4 to 6 weeks. |
| Complex Regional Pain Syndrome (CRPS) | Type 1: Formally known as reflex sympathetic dystrophy; Type 2: Formally known as causalgia; Etiology: May follow trauma or surgery. |
| Complex Regional Pain Syndrome (CRPS): Symptoms | Severe pain, edema, discoloration, osteoporosis, sudomotor changes, temperature changes, tropic changes, & vasomotor instability. |
| Complex Regional Pain Syndrome (CRPS): OT Intervention | Modalities to decrease pain; AROM to involved joints; ADL to encourage pain-free active use; Stress loading (weight bearing & joint distraction activities, including scrubbing & carrying activities); splinting to prevent contractures & enable activity. |
| Complex Regional Pain Syndrome (CRPS): What to AVOID | Interventions to avoid include PROM, passive stretching, joint mobilization, dynamic splinting, & casting. |
| Colles' Fracture | Commonly caused by people falling backward onto a hard surface and breaking their fall with extended outstretched hands; Fracture of the distal radius with dorsal displacement. |
| Smith's Fracture | Caused by falling onto flexed wrists; Fracture of the distal radius with volar displacement. |
| Humerus Fractures | Etiology: Fall onto an outstretched UE; Fractures of the greater tuberosity may result in rotator cuff injuries; Humeral shaft fractures may cause injury to the radial nerve resulting in wrist drop. |
| OT Evaluation for Fractures | History of injury; test results, edema, pain, AROM, Sensation, roles, occupations, ADL & activities related to roles. |
| What to avoid during OT Eval concerning fractures. | DO NOT assess PROM or STRENGTH until ordered by MD; Exceptions are humerus fractures which often begin with PROM or AAROM. |
| OT Intervention for Fractures: Immobilzation Phase | Stabilization and healing are the goals; AROM of joints above & below the stabilized part; Edema control: elevation, retro mass, & comp gar; Light ADL & role activities with no resistance, progress as tolerated. |
| OT Intervention for Fractures: Mobilization Phase | Consolidation is the goal. Edema control: Elevation, retro mass, contrast baths, & comp garments; AROM; Then progress to PROM when approved by physician (4 to 8 weeks). |
| Cumulative Trauma Disorders | AKA repetitive strain injuries (RSI); risk factors include repetition, static position, awkward postures, forceful exertions, & vibration. Most common include: DeQuervain's, Lateral & Medial Epicondylitis, and Trigger finger. |
| DeQuervain's | Stenosing tenosynovitis of the APL & EPB; painful swelling over radial styloid; positive Finkelstein's Test. |
| DeQuervain's Conservative Treatment | Thumb spica splint; activity/work modification; ice massage over radial wrist; gentle AROM of wrist & thumb to prevent stiffness. |
| DeQuervain's Post Operative Treatment | Thumb spica splint & gentle AROM (0-2 weeks); Strengthening, ADL, & role activities (2-6 weeks); unrestricted activity (6 weeks). |
| Lateral Epicondylitis | Overuse of the wrist extensors, especially the extensor carpi radialis brevis; AKA tennis elbow. |
| Medial Epicondylitis | Overuse of wrist flexors; AKA golfer;s elbow |
| Lateral & Medial Epicondylitis: Conservative Treatment | Elbow strap, wrist splint; ice & deep friction massage; stretching, activity/work modification; as pain decreases, begin strengthening. |
| Ape Hand | Injury of the distal median nerve. |
| Benediction Sign | Due to a high injury of the median nerve. |
| Wrist drop | Injury of the radial nerve. |
| +Froment's sign | Ulnar nerve laceration; assessment of the thumb adductor while laterally pinching paper. |
| Claw hand | Resulting from an ulnar nerve laceration. |
Created by:
saherrera