Rehabilitation: Post-Surgical TFCC arthroscopy Differential Diagnoses:

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Presentation transcript:

Rehabilitation: Post-Surgical TFCC arthroscopy Differential Diagnoses: Josh Bush Georgia College & State University, Milledgeville GA Objective: Treatment: Uniqueness: To present the case of a 21 year old, female softball player at Mercer University presenting a post-surgical TFCC arthroscopy. To explain the process of rehabilitation and its effects on functionality and time to return to play. Athlete has an anatomical misalignment of her radius and ulna; ulna is longer than usual. Radius and ulna are straight across instead of having that natural curve to allow for space in the TFCC. Injections after follow up with doctor: Cortisone and Toradol and a Medrol dose pack. Doctor thought nothing of the misalignment until further issues arose Post Surgical (after a month of general wrist strengthening) (2 weeks) Complete mobilization Ball squeezes Finger ROM (extension, flexion, AB/Adduction (2-4 Weeks) Modalities Parrafin wax Pulses ultrasound (2 times a week) Heat on some days Stim and ice after each session Exercises (ROM) Can hangs for increased extension Towel stretches CPM Isometric strengthening (manual resistance) Continued ball squeezes (4-6 weeks- Christmas Break) Take Home Sheet** (6-8 weeks) Modalities: Thermal ultrasound to 4 degrees Stim and Ice after each session Exercises Strengthening wrist exercises Bat pronation/supination radial/ulnar deviation Therabar flexion and extension Began trampoline tosses (throwing mechanics) (desired progression but presenting pain) Regression to lighter exercises No more throwing T-band Doctors follow up Doctor noticed Misalignment but didn’t address till now Patient Background: Height: 5’11” Weight: 160 lbs Age: 21 Ethnicity: Caucasian Sports: Softball: Starting catcher Golf as a hobby School: Mercer University Past Injuries: ganglion cyst on the radial side of the dorsal portion of her hand. Training level: 5 days a week, weekend tournaments. Original Evaluation: Ganglion cyst was original complaint. It was referred pain from the tear in the TFCC but the tear was unknown until after MRI. Joint mobes and ROM testing caused pain. Swinging a bat and throwing a ball caused pain. Ulnar deviation caused most pain during ROM. Conclusions: Although the athlete presents pain occasionally with wrist it has decreased enough for her to participate during the rest of the season. Athlete is currently able to do everything at practice as tolerated after being on an original hitting count. Differential Diagnoses: Ganglion Cyst TFCC tear Lunate dislocation Scaphoid fracture Misalignment of Radius and Ulna