Journal of hand therapy : official journal of the American Society of Hand Therapists
-
The majority of research on distal radius fractures consists of retrospective, descriptive studies of patients with unstable fractures requiring fixation. The purpose of this investigation was to report on impairments in flexibility, grip strength, and motor control and on the presence of swelling and atrophy immediately after cast immobilization of closed reductions of simple distal radius fractures. Sixteen adult subjects from Kaiser Permanente Medical Center, San Francisco, entered the study, and 13 completed it. ⋯ These measured impairments immediately after immobilization of simple radius fractures were greater than the reported impairments in patients after reduction of radius fractures with fixation 6 to 27 months after injury. To prevent long-term disability and recover flexibility, strength, and function, patients with simple distal radius fractures should be referred to a hand, occupational, or physical therapist for evaluation, education, and treatment after immobilization. Longitudinal studies are needed to quantify long-term functional recovery with regard to the type of fracture and the degree of impairment measured immediately after casting.
-
Recent studies of tendon repair are reviewed in order to help hand therapists make the most effective decisions regarding treatment of tendon injuries. Flexor tendons are emphasized by inclusion of the most current discussions and research on the different phases of intrinsic and extrinsic healing, the zones of injury, mechanical and chemical influences on tendon healing, the techniques of tendon suturing, and the timing of repair and rehabilitation. The purpose of the article is to update hand therapists on the latest research efforts concerning tendon healing in order to achieve better functional outcomes following repair of these structures.
-
Bone is among the most frequently injured of tissues, and bony injuries are among the conditions most commonly treated by hand therapists. An understanding of the biology of bony tissue repair, as well as the techniques available for its promotion, is therefore of the utmost importance to practitioners of hand therapy. This article addresses the biology of bony tissue repair, techniques currently available for the treatment of bony injuries, and management of specific bony injuries of the hand.
-
This article reviews the role that the peripheral nervous system plays in pain perception. The first section describes the functional properties of the primary sensory element-the nociceptor-and how its behavior is related to pain perception. The second section describes the current state of knowledge concerning the way our nociceptive sensing system changes as a result of tissue injury, including those changes related to sympathetic nervous system modulation of pain.
-
Myofascial pain syndromes of the upper extremity are common causes of pain that may follow trauma and are associated with acute or chronic musculoskeletal stress. The syndromes are characterized by the presence of the myofascial trigger point, a physical finding that is reliably identified by palpation. Local and referred pain are hallmarks of the syndrome, and the referred pain patterns may mimic such conditions as radiculopathy and nerve entrapment syndromes. Treatment is directed toward inactivating the myofascial trigger point, correcting underlying perpetuating factors, and restoring the normal relationships between the muscles of the affected functional motor units.