OAS II: UE injuries

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mariamandrussow
ID:
287530
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OAS II: UE injuries
Updated:
2014-10-30 00:40:15
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OAS II UE injuries
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OAS II: UE injuries
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OAS II: UE injuries
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  1. Look at entire unclothed UE for:
    • Posture
    • Guarding & Gesturing
    • Atrophy
    • Edema
  2. Wound Drainage = Exudate
    Sanguineous
    Serous
    Purulent
    Hematome
    • Bloody
    • clear or amber
    • pus
    • deep or dark red
  3. Wound care colors: what do they mean
    Red
    Yellow
    Black
    • Red: healing
    • Yellow: exudate requiring cleansing & debridement
    • Black: necrotic and requires debridement
  4. Scars:
    Hypertrophic
    Keloid
    • Hypertrophic: slightly raised, red
    • Keloid: raised

    Scars can cause contractures, which resist PROM
  5. Color: Immature vs. Mature scar
    • Immature: red or purple
    • Mature: neutral color
  6. Edema evaluation, use Volumeter or circumferential measurement (fabric ruler). 
    Volumeter contraindicated when:
    • Open wounds
    • Percutaneous pinning
    • Plaster cast
    • Vasomotor instability
  7. Evaluation: Sensibility
    Inspect for..
    • Dryness
    • Moistness
    • Calluses
    • Blisters
    • Touch, pain, sensory tests/assessments
  8. Hand function tests should NOT replace assessments of ADL and other areas of occupation!
  9. Game Keeper's (Skier's) Thumb
    • Torn Ulnar Collateral Ligament
    • -test reveals extreme palmer aBduction of thumb
  10. De Quervain's Tenosynovitis
    • Extensor Policis Brevis
    • ABductor Policis Longus

    • Causing inflammation at snuff box
    • Test: Finkelstein
  11. Dupuytren's Contracture
    • Thickening and shrinking of the palmar fascia
    • Most common in ring and little fingers
  12. Basic Scar Interventions
    • Silicone
    • Compression
    • Massage (cross friction)
    • Desensitization
  13. Antideformity hand positioning:
    • Intrinsic Plus!
    • (to prevent claw hand, MCP extended & IP flextion = bad)
  14. Tendon repair MUST follow the protocol from the surgeon
    • Immobilization
    • Tendon Gliding & Blocking
    • passive Stretching of antagonist
    • Controlled progressive Exercises
  15. 3 Stages of CRPS
    • Traumatic: pain, pitting edema, discoloration, REVERSIBLE 3 months
    • Dystrophic: pain, brawny edema, stiffness, redness, heat, glossy, REVERSIBLE 6-9 months
    • Atrophic: decreased pain, fixed contractures, pale, dry, cool, NON-REVERSIBLE Years or indefinite
  16. Therapy for CRPS
    • Reduce Edema
    • NO immobilization in a splint
    • NO PROM
    • Reduce Pain (meds, modalities, sympathetic blocking)
    • Reset Sensory Thresholds:
    • Vibration
    • Contrast
    • Desensitization
    • Vasomotor Callenges:
    • Stress loading
    • Temperature biofeedback
    • Posture

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