1. Rehabilitative Strategies Following Hand Fractures
Peyton L. Hays, MD, Tamara D. Rozental, MD 
Hand Clinics 
Volume 29, Issue 4, Pages (November 2013)
DOI: /j.hcl
Copyright © 2013 Elsevier Inc. Terms and Conditions

2. Fig. 1
Digital wrapping with Coban from distal to proximal is an inexpensive and easily applied technique to control postinjury edema.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

3. Fig. 2
Digital flexion bands are used to maximize passive range-of-motion gains via constant load application across the affected joint.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

4. Fig. 3
Digital blocking exercises enhance tendon glide and prevent tissue adherence. Isolated motion across the distal IP joint with the proximal IP (PIP) joint extended promotes flexor digitorum profundus motion (left image). In contrast, motion across the PIP joint with the metacarpophalangeal joint extended isolates flexor digitorum superficialis gliding (right image).
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

5. Fig. 4
Tendon gliding is further enhanced with place and hold fist exercises. The hook fist (left image) emphasizes motion between the superficial and deep flexor tendons. The full fist (middle image) maximizes deep flexor excursion. In contrast, the straight fist (right image) maximizes superficial flexor motion.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

6. Fig. 5
Putty exercises (left and right images) promote not only strengthening but also tendon glide and range of motion. This simple and effective modality is easily incorporated into the home exercise regimen.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

7. Fig. 6
Splinting of the IP joints in extension and the MCP joints in approximately 70° flexion maintains tension across the small joint collateral ligaments. This position of safe immobilization should be considered when immobilization of the hand and digits is necessary.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

8. Fig. 7
Dynamic splints, such as the 3-point LMB finger extension splint, deliver controlled, constant load across the joint. Dynamic splints may be removed for further range-of-motion exercises.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

9. Fig. 8
Static-progressive splinting is a commonly used modality in the authors’ clinic. In this example, a stiff PIP joint is effectively mobilized with progressive, incremental adjustments to joint force and position.
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions

10. Fig. 9
As therapy progresses, specific exercises are introduced to address common work and recreational activities. Therapist feedback may be used to correct improper hand position and technique (left image) as demonstrated during this handwriting exercise in which the patient is reminded to maintain ring and small finger flexion (right image).
Hand Clinics  , DOI: ( /j.hcl )
Copyright © 2013 Elsevier Inc. Terms and Conditions