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treatment-article3

Sprained finger joint

SportNetDoc

Early active mobilisation of volar plate avulsion fractures.

Gaine WJ, Beardsmore J, Fahmy N. Injury 1998 Oct;29(8):589-91.

This is a prospective follow up of 190 consecutive cases of volar plate avulsion fractures. A standard management regimen of immediate, active movement was followed in all cases and physiotherapy was rarely required. Of the 190 patients, 162 were followed up for at least one year. An excellent or good outcome was achieved in 98 per cent. Patients presenting more than three weeks from injury had a worse outcome. The size and displacement of the avulsed fragment did not affect the outcome. For the stable joint, early active mobilisation with minimal or no splintage provides a good result.

KONDITION

step4

Inflammation of the tendon sheath on outer wrist

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH ON THE OUTER WRIST
(TENOSYNOVITIS STYLOIDEAE RADII, DE QUERVAIN)

STEP 4
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(20 min)

Stand with outstretched arm by your side with fist lightly clenched. Rotate your arm so that the thumb is drawn inwards and backwards as far as possible. Bend your wrist as far as it can go, so that the back of the hand faces downwards. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Go down on all fours with your fingers and elbow facing towards the knees. Your arms should be outstretched. Move your body backwards so that increased stretching is felt in the forearm. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit at a table with the injured arm hanging over the edge with the palm facing downwards. Use the other arm to apply pressure on the back of the injured hand so that the injured lower arm becomes increasingly stretched on the upper side. Repeat the exercise where the injured hand is alternately pressed from side to side. The injured arm should finally be turned over and the exercise repeated by pressing the underside of the hand so that the injured lower arm becomes increasingly stretched on the under side. The stretching positions should be held for 20 seconds followed by 20 seconds of rest before repeating.

Bend your wrist up as far as possible and press with the opposite hand. Hold the position for 20 seconds. Repeat the exercise pressing the wrist downwards. Hold the position for 20 seconds.

Press your hands together and lift your elbows while holding your arms in front of your chest. Hold the position for 20 seconds and relax for 20 seconds before repeating.

STYRKE
(40 min)

Using an elastic band around the back of the injured hand, move the wrist upwards while keeping the elastic taut.

Sit at a table with the side of the injured hand resting on the table edge. Place the elastic around the thumb, draw it downwards over the back of the hand and hold with the good hand. Slowly rotate the lower arm from side to side to stretch the elastic.

Let the injured hand hang over the edge of a table with the palm facing downwards. Move the hand slowly up and down while holding a weight. Support the injured arm with the good arm.

Lie on your back with support at the elbow. Slowly bend and stretch the elbow while holding a weight.

Squeeze a soft ball.

Put an elastic band around your fingers. Spread your fingers so that the elastic is stretched.

Let the injured hand hang over the edge of a table with the back of the hand facing downwards. Holding a weight, slowly move your hand up and down while supporting the arm with the good hand.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step3

Inflammation of the tendon sheath on outer wrist

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH ON THE OUTER WRIST
(TENOSYNOVITIS STYLOIDEAE RADII, DE QUERVAIN)

STEP 3
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(20 min)

Stand with outstretched arm by your side with fist lightly clenched. Rotate your arm so that the thumb is drawn inwards and backwards as far as possible. Bend your wrist as far as it can go, so that the back of the hand faces downwards. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Go down on all fours with your fingers and elbow facing towards the knees. Your arms should be outstretched. Move your body backwards so that increased stretching is felt in the forearm. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit at a table with the injured arm hanging over the edge with the palm facing downwards. Use the other arm to apply pressure on the back of the injured hand so that the injured lower arm becomes increasingly stretched on the upper side. Repeat the exercise where the injured hand is alternately pressed from side to side. The injured arm should finally be turned over and the exercise repeated by pressing the underside of the hand so that the injured lower arm becomes increasingly stretched on the under side. The stretching positions should be held for 20 seconds followed by 20 seconds of rest before repeating.

Bend your wrist up as far as possible and press with the opposite hand. Hold the position for 20 seconds. Repeat the exercise pressing the wrist downwards. Hold the position for 20 seconds.

Press your hands together and lift your elbows while holding your arms in front of your chest. Hold the position for 20 seconds and relax for 20 seconds before repeating.


STYRKE
(40 min)

Using an elastic band around the back of the injured hand, move the wrist upwards while keeping the elastic taut.

Sit at a table with the side of the injured hand resting on the table edge. Place the elastic around the thumb, draw it downwards over the back of the hand and hold with the good hand. Slowly rotate the lower arm from side to side to stretch the elastic.

Let the injured hand hang over the edge of a table with the palm facing downwards. Move the hand slowly up and down while holding a weight. Support the injured arm with the good arm.

Lie on your back with support at the elbow. Slowly bend and stretch the elbow while holding a weight.

Squeeze a soft ball.

Put an elastic band around your fingers. Spread your fingers so that the elastic is stretched.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step2

Inflammation of the tendon sheath on outer wrist

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH ON THE OUTER WRIST
(TENOSYNOVITIS STYLOIDEAE RADII, DE QUERVAIN)

STEP 2
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(20 min)

Stand with outstretched arm by your side with fist lightly clenched. Rotate your arm so that the thumb is drawn inwards and backwards as far as possible. Bend your wrist as far as it can go, so that the back of the hand faces downwards. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Go down on all fours with your fingers and elbow facing towards the knees. Your arms should be outstretched. Move your body backwards so that increased stretching is felt in the forearm. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit at a table with the injured arm hanging over the edge with the palm facing downwards. Use the other arm to apply pressure on the back of the injured hand so that the injured lower arm becomes increasingly stretched on the upper side. Repeat the exercise where the injured hand is alternately pressed from side to side. The injured arm should finally be turned over and the exercise repeated by pressing the underside of the hand so that the injured lower arm becomes increasingly stretched on the under side. The stretching positions should be held for 20 seconds followed by 20 seconds of rest before repeating.

Bend your wrist up as far as possible and press with the opposite hand. Hold the position for 20 seconds. Repeat the exercise pressing the wrist downwards. Hold the position for 20 seconds.

Press your hands together and lift your elbows while holding your arms in front of your chest. Hold the position for 20 seconds and relax for 20 seconds before repeating.

STYRKE
(40 min)

Sit at a table with the injured hand over the edge and the palm facing upwards. Use the good hand to place slight pressure on the injured hand and hold the position for 10 seconds. Rest for 10 seconds before repeating.

Sit at a table with your hand over the edge and the palm facing downwards. Using the good hand apply slight pressure to the injured hand and hold the position for 10 seconds. Relax for 10 seconds before repeating.

Squeeze a soft ball.

Put an elastic band around your fingers. Spread your fingers so that the elastic is stretched.

Curl a tea towel with outstretched arms.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step1

Inflammation of the tendon sheath on outer wrist

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH ON THE OUTER WRIST
(TENOSYNOVITIS STYLOIDEAE RADII, DE QUERVAIN)

STEP 1
The indications of time after stretching, coordination training and strength training show the division of time for the respective type of training when training for a period of one hour. The time indications are therefore not a definition of the daily training needs, as the daily training is determined on an individual basis.

KONDITION
Unlimited: Cycling. Running.

UDSPÆNDING
(20 min)

Stand with outstretched arm by your side with fist lightly clenched. Rotate your arm so that the thumb is drawn inwards and backwards as far as possible. Bend your wrist as far as it can go, so that the back of the hand faces downwards. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Go down on all fours with your fingers and elbow facing towards the knees. Your arms should be outstretched. Move your body backwards so that increased stretching is felt in the forearm. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit at a table with the injured arm hanging over the edge with the palm facing downwards. Use the other arm to apply pressure on the back of the injured hand so that the injured lower arm becomes increasingly stretched on the upper side. Repeat the exercise where the injured hand is alternately pressed from side to side. The injured arm should finally be turned over and the exercise repeated by pressing the underside of the hand so that the injured lower arm becomes increasingly stretched on the under side. The stretching positions should be held for 20 seconds followed by 20 seconds of rest before repeating.

Bend your wrist up as far as possible and press with the opposite hand. Hold the position for 20 seconds. Repeat the exercise pressing the wrist downwards. Hold the position for 20 seconds.

Press your hands together and lift your elbows while holding your arms in front of your chest. Hold the position for 20 seconds and relax for 20 seconds before repeating.

STYRKE
(40 min)

Sit at a table with the injured hand on a ball and roll slowly from side to side.

Sit at a table with the injured hand over the edge with the palm facing upwards. Bend and stretch the wrist.

Sit at a table with the injured hand over the edge with the palm facing downwards. Bend and stretch the wrist.

Sit at a table with the injured hand on a ball and roll slowly backwards and forwards.

Sit at a table with your hand over the edge and the palm facing downwards. Using the good hand apply slight pressure to the injured hand and hold the position for 10 seconds. Relax for 10 seconds before repeating.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

treatment-article

Inflammation of the tendon sheath on outer wrist

SportNetDoc

Work-related upper extremity musculoskeletal disorders.

Mani L, Gerr F. Prim Care 2000 Dec;27(4):845-64.

Upper extremity musculoskeletal disorders such as DeQuervain’s tendonitis, carpal tunnel syndrome, and rotator cuff tendonitis have become increasingly common among working people in the United States. Extensive epidemiological investigation indicates that the adverse ergonomic exposures of force, repetition, vibration and certain postures are risk factors for development of many of these disorders. Assessment of patients with possible work-related upper limb disorders requires eliciting information about the illness, performing an examination about the illness, and obtaining information about adverse ergonomic exposures on and off from work. Treatment can only be successful when exposure to adverse ergonomic risk factors is reduced or eliminated.

examination-article

Inflammation of the tendon sheath

SportNetDoc

Sonography of the hand and wrist.

Teefey SA, Middleton WD, Boyer MI. Semin Ultrasound CT MR 2000 Jun;21(3):192-204.

Not only is the anatomy of the hand and wrist complex, but also its pathologic conditions are quite diverse. Although plain radiographs, CT, arthrography, and MRI have traditionally been used to evaluate the hand and wrist, ultrasound is beginning to take its place alongside these more traditional imaging modalities and is being ordered with increasing frequency by orthopedic surgeons. This article reviews the pertinent gross anatomy and sonographic technique used to scan the hand and wrist and also describes the sonographic findings associated with the most common hand and wrist pathologic conditions. These include soft tissue tumors, tenosynovitis, tendinous and ligamentous injuries of the hand, Dupuytren’s contracture, foreign bodies, and carpal tunnel syndrome (CTS).

cause-article2

Inflammation of the tendon sheath

SportNetDoc

Rupture of the extensor pollicis longus tendon.

Bonatz E, Kramer TD, Masear VR. Am J Orthop 1996 Feb;25(2):118-22.

Rupture of the extensor pollicis longus (EPL) tendon after nondisplaced fracture of the distal radius is a known complication, but can also occur in nonrheumatoid patients without a history of fracture. This study is a retrospective analysis of seven patients treated between 1985 and 1992. Five EPL ruptures occurred with nondisplaced Colles’ fractures. Two involved a chronic tenosynovitis of the second dorsal extensor compartment of the wrist. The age of the patients ranged from 29 years to 68 years (mean, 42 years). Length of follow-up ranged from 6 weeks to 62 months (mean, 30 months). Rupture occurred at a median of 7 weeks (range, 2 weeks to 11 months) from the time of the distal radius fracture. Three extensor indicis proprius tendons and four free palmaris longus tendon grafts were performed. At final follow-up, six patients had an extensor lag < 10 degrees or normal thumb interphalangeal joint motion. One patient had a 25 degrees extensor lag. The causes of EPL rupture include mechanical irritation, attrition, and vascular impairment leading to delayed rupture. Synovitis of the extensor carpi radialis due to repetitive use may invade the EPL tendon and lead to rupture. Extensor indicis proprius transfer or free palmaris longus grafts yield good results after EPL rupture.