By S. Brent Brotzman MD, Kevin E. Wilk PT DPT
A crew of world-class participants current you with authoritative tips at the most recent assessment, analysis, and rehabilitation techniques for a whole diversity of musculoskeletal difficulties. the result's an imperative consultant to making plans powerful rehabilitation and making sure optimum post-surgical results for the commonest accidents to the joints and muscular system.
- Differential prognosis integrated firstly of every bankruptcy for fast and actual prognosis of musculoskeletal conditions
- Assess a physique joint's diversity speedy with the neighborhood overview packing containers in each chapter
- Find info simply with new portrait orientated rehabilitation protocols
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Sample text
1-33), no significant prominence of the distal fragment (palmarly displaced) in the palm, and no extensor lag of the involved finger. Radiographic Examination On a lateral radiograph, the angle of the metacarpal fracture is determined by drawing lines down the shafts of the metacarpal and measuring the resultant angle with a goniometer. Treatment Treatment is based on the degree of displacement, as measured on a true lateral radiograph of the hand (Fig. 1-34), Metacarpal neck fractures are usually impacted and angulated, with the distal fragment displacing palmarly because of the pull of the Figure 1-33 Malrotation of a fracture (andthus the finger), 1 • Hand and Wrist Injuries _ Figure 1-34 "Boxer's" fracture.
Physician Sports Med 26(6):226, 1998. however, static PIP joint extension splinting is recommended for 6 weeks to allow healing of the central slip. Avulsionfractures involving the dorsal margin of the middle phalanx occur at the insertion of the central slip. These fractures may be treated by closed technique; however, if the fragment is displaced more than 2 mm proximally with the finger splinted in extension, ORIF of the fragment is indicated. 1 REHABILITATION PROTOCOL 0 Hand and Wrist Injuries _ After Volar Proximal Interphalangealjoint Dislocation or Avulsion Fracture AFTER CLOSED REDUCTION An extension gutter splint is fitted for continuous wear with the PIP joint in neutral position.
The level of retraction of the FDP generally denotes the force of the avulsion. Leddy and Packer (1977) described three types ojFDP avulsionbased on where the avulsed tendon retracts. The treatment is based on the anatomy of the injury. Classification ofJersey Finger Injury (Flexor Digitorum Profundus Avulsion) TYPE I INJURY The avulsed FDP tendon retracts into the palm (no bony fragment). Both vincula are avulsed, thereby disrupting the blood supply. Early reattachment at the distal phalanx «10 days) gives the best results.
