Hand Disorder
CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome is a condition in which the median nerve is compressed at the wrist in the tunnel formed by the carpal bones and the transverse carpal ligament. The carpal tunnel contains the median nerve and several flexor tendons of the fingers and thumb. Various factors can cause an increase in pressure in the carpal tunnel, resulting in irritation of the median nerve. Carpal tunnel is also sometimes associated with “double crush syndrome,” in which a proximal trauma (neck, shoulder, or elbow) renders the distal nerve (wrist) vulnerable.
COLLIES FRACTURE
The fracture is most commonly caused by people falling onto a hard surface and breaking their fall with outstretched arms. It is a fracture of the distal radius in the forearm with a posterior and radial displacement of the wrist and hand. The fracture is sometimes referred to as a “dinner fork” deformity due to the shape of the resultant forearm. Colles’ fractures are often seen in people with osteoporosis.
How can the physical therapist help?
Physical therapy offers several interventions to accelerate the healing process. The most effective interventions are articular mobilizations, active release techniques, education about the condition, wearing a splint, and exercises. When performing mobilization techniques, the Physical therapy can execute passive movements of the hand and use specific mobilizations to stretch the joint capsule and allow for a better quality of movement. The therapist can also prescribe different exercises meant to increase hand & wrist movement, stretch the capsule, and increase the strength of the forearm. Other methods can be employed, such as the use of TENS or interferential current for pain management and neuro-proprioceptive taping to improve movement quality and reduce pain. In many cases, Physical therapy treatments are also combined with Acupuncture to help stretch muscle fibers, capsule and relieve pain. Combining these two methods increases the patient’s chances of having a speedy recovery.
SMITH FRACTURE
It is sometimes known as a reverse Colles’ fracture of the distal radius. It is caused by a direct blow to the dorsal forearm or falling onto flexed wrists, as opposed to a Colles’ fracture which occurs as a result of falling onto wrists in extension. Smith’s fractures are less common than Colles’ fractures.The distal fracture fragment is displaced volarly (ventrally), as opposed to a Colles’ fracture which the fragment is displaced dorsally.
HAND ARTHRITIS
Arthritis is a general term for inflammation in the joints. Arthritis can occur in numerous forms. The most common is osteoarthritis, a condition in which the cartilage, the protective cushioning between the joints, wears out. When this happens, the bones rub directly against other bones. This causes structural changes that can be seen on X-rays. Bone deposits or bone spurs known as osteophytes (Heberden’s and Bouchard’s Nodes) may develop on the edges of the joints. The soft tissues that stabilize joints may also show signs of wear.