By David C. Saidoff BS PT, Andrew L. McDonough EdD PT
Serious Pathways offers a clinically-based, problem-solving method of rehabilitation that integrates innovations from activities medication, actual and occupational remedy, geriatrics, ergonomics, kinesiology, and physiatry. It makes use of a case-study structure that simulates genuine encounters with sufferer and covers the various maladies most typically visible in outpatient rehabilitation.
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Additional resources for Critical Pathways in Therapeutic Intervention: Upper Extremities
I::': • R,,:,c. -,,r. rist flexion ~'I I \ Ine synovia secretarial r·:. ,:-:': infection. ' 7 ,5:: _'nIdrome. Ihoracic out :2[:,al tunnel. ::-:"ring at the :-brupt angle :'~0ximal and :"::c:1ce of pos c~ depression ,1 c,,-ion. 3 The : at the inter ': angle com ~\e at a more :c:1 the nerve -,\Tist exten :-:al proximal : ought to be Conservative cjef of hand r therapeutic B ~L . 4-8 A, Phalen's test: The patient is asked to report any sensory changes in the median nerve-innervated area after holding his wrists flexed for 1 minute B, Tinel's sign: The examiner taps the hand from the fingertips proximally to the palm.
Positive radiographic findings may demon strate cyst formation at the fracture site as well as sclerosis of fracture surfaces. Continued move ment will contribute to nonunion of bone fragments. Thus, even if no fracture is visualized, a scaphoid cast should be applied for several weeks.!! This below-elbow cast should include the prox imal phalanx of the thumb while holding it roughly opposite the ring finger and not in wide abduc tion, since that interferes with function and may displace fracture fragments.
This occurs because the lunate acts as a wedge to shear the distal 2 cm of the radius off in a dorsal direction. 3 39 _ _ _ _ 40 Part I Ulna Lunate Hand and Wrist Hamate Capitate ,... 5-1 Profile of a Colles fracture (From Peterson L, Renstrom P Sports injuries. their prevention and treatment, London, 1986, Martin Dunitz, Ltd I • Comminution of the thin cortex, especially in osteoporotic bone of the elderly. A cross section of the radius can show how the thick cortical bone of the shaft thins out to form only a thin layer over the cancellous bone at the distal end.