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Chapter 15 – The Wrist, Hand, and Fingers

Chapter 15 – The Wrist, Hand, and Fingers. Pages 552-555. 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.

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Chapter 15 – The Wrist, Hand, and Fingers

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  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 • Tinel’s Sign • Figure 15-25, page 553 • Phalen’s 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 • Smith’s Fracture • Also called reverse Colles’ fracture • Distal radius fracture that is displaced palmarly • Evaluative Findings • Table 15-8, page 556

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