1. The Wrist & Hand

2. Bony Anatomy The Wrist - Made up of 8 bones, called carpals - Transverse 2 rows The Hand - Made up of 5 metacarpals and 5 digits - One digit has 3 phalanges, except the thumb The Joint is condyloid

3. Posterior Muscles →  Anterior Muscles

4. ROM’s for the Wrist Wrist ExtensionWrist Flexion

5. ROM’s for the Wrist Ulnar DeviationRadial Deviation

6. ROM’s of the Fingers Finger Extension Finger Flexion Finger Abduction Finger Adduction

7. Wrist Fractures MOI: Direct blows or falling on hand –Colle’s Fx S/S: Reduced function, crepitus, edema, & pt.tender Tx. Splint, RICE, Refer to MD Tests: None

8. Wrist Fractures MOI: Falling on outstretched hand –Scaphoid Fx S/S: Pt. Tender over anatomical snuffbox, edema, Pn with extension Tx. Splint, RICE, Check pulse, Refer to MD Tx. Splint, RICE, Check pulse, Refer to MD Tests: Spider Test

9. Dislocations/Subluxations MOI: Direct blows S/S: LOF, edema, deformity Tx: Splint, RICE, Check pulse Tests: Murphy’s Sign

10. Sprains: Gamekeeper’s Thumb MOI: Overstretching of thumb, AB or ADD –LCL or MCL S/S: Edema, Pn with movement, Pt. Tender Tx: RICE, Thumb Spica Tests: Gamekeeper’s Test, Varus/Valgus

11. Impingement MOI: Repeated Stress S/S: Pt. Tender, Pn, Numbness, Tingling, loss of strength Tx: Rest & Ice, Bracing Tests: Phalen’s, Pinch Grip

12. Carpal Tunnel Syndrome MOI: Overuse or prolonged flexion of the wrist S/S: Tingling in thumb & middle fingers, ↓ Grip strength, Tx: Braces for days/months, Cortisone shots or other meds, surgery, strengthening exercises Tests:Phalen’s

13. Tendonitis MOI: Overuse of the hand S/S: Edema and Point Tender Tx: RICE Tests: Finkelstein’s Test

14. Ganglion Cyst Fluid-filled sac in the synovial membrane, or a herniation of the sheath MOI: Degeneration of the sheath S/S: Pn, ↓ ROM, Small lump (usually on posterior wrist) Tx: Donut pad, Ice, Refer to MD if does not heal after 1 wk.

15. Mallet Finger MOI: direct blow to outstretched finger or caught in jersey, tearing the extensor tendon –Jersey finger is a sprain S/S: Pt. Tender, Flexed DIP Joint Tx: Splint, ICE, Refer to MD Tests: None