PIPJ Boutonniere Deformity - Serial Casting

The most effective means of reducing a fixed flexion deformity is through the use of serial casting. The cast is fabricated, bearing in mind the necessity for a 3 point pressure to be applied, using biomechanical principles, whereby the MCPJ is stabilized by a volar slab that extends into the palm and through the use of levers. The proximal phalanx and metacarpal of the corresponding finger form 1 lever and the middle and distal phalanx forms a second lever. The dorsum of the PIPJ remains free from pressure. A circumferential layer is then applied to the finger while the 2 levers are passively extended within the cast to correct the fixed flexion deformity of the PIPJ as much as possible. On

PIPJ Dislocations -Late Presentation management

PIPJ dislocations frequently present at a late stage - usually 3 months following the injury. The GP generally diagnoses a finger sprain and suggests that the patient buddy straps the finger to the adjacent finger. They generally do not mobilize the finger for a few weeks and at 1 month they have developed a pseudo Boutonniere deformity, often with reciprocal hyperextension of the DIP joint. These fixed flexion deformities usually have an associated collateral ligament injury. It is not possible to correct these deformities adequately with splinting alone, because the splint is removable and the patient does not permit adequate time spent in the splint to provide an adequate stress that will

Rehabilitation of Dystonia

My phenomenal colleague Katherine Lee​ is a highly esteemed Hand Therapist and specialist in the field of the musician's hand. This article explains task-specific focal hand dystonia and sensory-motor rehabilitation. When you watched the patient's video, did you detect the focal hand dystonia of her little finger? #musician #therapy #focalhanddystonia #katherinebutler #handrehab #violin #injury #rehabilitation #handtherapy #robynmidgley #music #pain #CMCIOA #dequervain #posturalinstability #sensorytricks

CMC I OA Splint

CMC I OA splint provided to support the base of the thumb during play and at rest musicianshand #violin #hand #dystonia #rehab #tension #orchestra #music #cubitaltunnel #osteoarthritis #posture #handrehab #exercise #workdisorder #rest #playschedule #cmc #osteoarthritis

Violinist - Assessment Findings

Follow-up from the Violinist players assessment video. Objective Findings: 💠 Positive shoulder sign bilaterally. 💠 Positive crank and grind test bilaterally. 💠 Small joint OA. 💠 de Quervain’s Stenosing Tenosynovitis. 💠 Negative phalanxes Test bilaterally 💠Cubital Tunnel Syndrome. 💠Dystonia in the little finger 💠 Increased upper Trapezius tension and atrophy of left upper Trapezius muscle. This case demonstrates a multitude of problems that have arisen from years of playing the violin. I referred her to a colleague for spinal correction and alignment. Treatment has included the following: 💠 CMCI OA orthoses 💠 Elbow extension splint for use at night 💠 Sensory program for Dystonia. �

Dupuytren's Fasciectomy - Are we rehabilitating correctly?

Dupuytren's Disease - How are we rehabilitating chronic joint stiffness following a Dupuytren's Fasciectomy? This week we will be presenting Ian's case. Follow his journey and let us start the conversation about rehabilitation #handconsultsa #rehab #cmms #dupuytren #handsurgery #robynmidgley

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