Common Conditions and Management Techniques

Hand Conditions

Finger Fractures and Dislocations

Finger orthosis
Edema management
Range of motion exercises

Arthritis

Paraffin and moist heat
Edema management
Range of motion exercises
Isometric strengthening exercises
Joint protection techniques
Adaptive equipment

Thumb Basal Joint Arthritis

Hand-based thumb spica
Deep tissue massage and thenar eminence
Range of motion exercises
Education regarding join protection principles
Adaptive equipment

Flexor Tendon Laceration

Dorsal blocking orthosis
Range of motion exercises
Edema and scar management

Extensor Tendon Laceration

Paraffin and moist heat
Edema management
Range of motion exercises
Isometric strengthening exercises
Joint protection techniques
Adaptive equipment

Mallet Finger

Finger extension orthosis
Edema management
Update every 2-4 weeks

Trigger Thumb / Finger

Finger / thumb orthosis
Edema management
Activity modification

Skier’s Thumb

(Ulnar collateral ligament injury)

Hand-based thumb spica
Range of motion exercises
Edema management

Amputations

Whirlpool and wound care
Dressing changes
Protective orthosis if needed
Range of motion exercises
Desensitization

Burns and Frostbite

Whirlpool and wound care
Dressing changes
Orthotic fabrication (if needed)
Range of motion exercises

Wrist Disorders

Carpal Tunnel Syndrome

Wrist orthosis or splint
Tendon and median nerve glides
Education regarding avoidance of aggravating activities

Extensor Tendon Laceration

Forearm-based thumb spica
Edema management
Range of motion and strengthening exercises
Activity modification

Wrist Tendonitis

Wrist immobilization orthosis or splint (custom splinting)
Edema management
Activity modification and symptom management

Scaphoid Fractures

Forearm-based thumb spica with ulnar clamshell
Edema management
Range of motion and strengthening following bone healing

Intersection Syndrome

(Inflamation at the intersection of the thumb extensors and radial wrist extensors approx. 4-6 cm proximal to dorsal wrist crease)

Forearm-based thumb spica
Edema management
Activity modification and symptom management

Wrist Sprain

Wrist immobilization orthosis or splint
Edema management
Range of motion exercises / strengthening
Activity modification and symptom management

Wrist Fractures

Wrist orthosis
Edema management
Range of motion exercises
Strengthening exercises following bone healing

Degenerative Joint Disease of the Wrist

Wrist immobilization orthosis or splint
Paraffin and moist heat
Activity modifications, adaptive equipment, and joint protection principles
Range of motion exercises

Midcarpal Instability

Forearm-based ulnar gutter | Radial clamshell orthosis
Edema management
Education regarding avoidance of aggravating activities

Thoracic Outlet Syndrome

(Compression of the brachial plexus through area bordered by first rib, clavicle, and neck muscles. Symptoms include numbness and tingling in the arm or hands, pain radiating up or down the arm, hand, or neck, and occasional muscular weakness.)

Brachial plexus nerve glides
Postural stretches and exercises
Strengthening exercises
Education regarding proper posture

Elbow Disorders

Tennis and Golfer’s Elbow

Wrist immobilization splint / aircast
Modalities as needed
Deep tissue massage
Forearm stretches
Strengthening
Activity modification and symptom management

Cubital Tunnel Syndrome

Elbow gel pad
Elbow extension orthosis or splint
Ulnar nerve glides
Education regarding avoidance of aggravating activities

Radial Nerve Palsy

Dorsal extension outrigger orthosis
Passive range of motion exercises
Monitor monthly for regeneration / update exercises