Necrotic Wound & Fractured Finger in an Elderly Lady

This elderly lady fell on the 17-08-18 and fractured her left little finger as well as lost skin over the dorsum of her wrist and hand, which became necrotic. On the 11-09-18 she had a wound debridement and a split skin graft. Image I shows her initial presentation. The oedema was accumulating distal to the skin graft and was becoming brawny. There was very poor active range of motion. The CMMS technique was applied. The circumferential cast provides the right amount of pressure to stimulate the superficial lymphatics. Coban was applied to the fingers to reduce the oedema. The patient was taught how to perform a hook fist within the intrinsic minus cast. The movement pattern was more effective with the cast in situ as the wrist is stabilized within the cast. Follow her journey as we rehabilitate her hand with minimal attendance at hand therapy through the use of the CMMS technique #HandJournal #HandConsultSA