The Pediatric Clinic 425-481-1933 | The Hand Clinic 425-892-2243 [email protected]

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
  • Paraffin and moist heat
  • Edema management
  • Range of motion exercises
  • Isometric strengthening exercises
  • Joint protection techniques
  • Adaptive equipment
  • Finger extension orthosis
  • Edema management
  • Update every 2-4 weeks
  • Finger / thumb orthosis
  • Edema management
  • Activity modification

(Ulnar collateral ligament injury)

  • Hand-based thumb spica
  • Range of motion exercises
  • Edema management

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

    Wrist Disorders

     

    • Wrist orthosis or splint
    • Tendon and median nerve glides
    • Education regarding avoidance of aggravating activities
    • Forearm-based thumb spica
    • Edema management
    • Range of motion and strengthening exercises
    • Activity modification
    • Wrist immobilization orthosis or splint (custom splinting)
    • Edema management
    • Activity modification and symptom management
    • Forearm-based thumb spica with ulnar clamshell
    • Edema management
    • Range of motion and strengthening following bone healing

    (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 immobilization orthosis or splint
    • Edema management
    • Range of motion exercises / strengthening
    • Activity modification and symptom management
    • Wrist orthosis
    • Edema management
    • Range of motion exercises
    • Strengthening exercises following bone healing
      • Wrist immobilization orthosis or splint
      • Paraffin and moist heat
      • Activity modifications, adaptive equipment, and joint protection principles
      • Range of motion exercises
      • Forearm-based ulnar gutter | Radial clamshell orthosis
      • Edema management
      • Education regarding avoidance of aggravating activities

      (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

      • Wrist immobilization splint / aircast
      • Modalities as needed
      • Deep tissue massage
      • Forearm stretches
      • Strengthening
      • Activity modification and symptom management
      • Elbow gel pad
      • Elbow extension orthosis or splint
      • Ulnar nerve glides
      • Education regarding avoidance of aggravating activities
      • Dorsal extension outrigger orthosis
      • Passive range of motion exercises
      • Monitor monthly for regeneration / update exercises