Clinical Examination of the Wrist

Skirven, Terri M.; Osterman, A. Lee

doi:10.1016/b978-0-323-05602-1.00007-6

Cited by 8 publications

(10 citation statements)

References 68 publications

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“…The finger extension test is positive when resisted extension of the fingers with the wrist in flexion is painful. 17 To perform the Watson test, the patients’ wrist is in slight dorsal flexion and ulnar deviation, with the researchers’ thumb on ST and fingers wrapped around the distal radius. Then, the researcher moves the patients’ wrist radially and in palmar flexion.…”

Section: Methods and Analysismentioning

confidence: 99%

Clinically SUspected ScaPhoid fracturE: treatment with supportive bandage or CasT? ‘Study protocol of a multicenter randomized controlled trial’ (SUSPECT study)

et al. 2020

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IntroductionSome scaphoid fractures become visible on radiographs weeks after a trauma which makes normal radiographs directly after trauma unreliable. Untreated scaphoid fractures can lead to scaphoid non-union progressing to osteoarthritis. Therefore, the general treatment for patients with a clinically suspected scaphoid fracture and normal initial radiographs is immobilisation with below-elbow cast for 2 weeks. However, most of these patients are treated unnecessarily because eventually less than 10% of them are diagnosed with an occult scaphoid fracture. To reduce overtreatment and costs as a result of unnecessary cast treatment in patients with a clinically suspected scaphoid fracture and normal initial radiographs, we designed a study to compare below-elbow cast treatment with supportive bandage treatment. We hypothesise that the functional outcome after 3 months is not inferior in patients treated with supportive bandage compared to patients treated with below-elbow cast, but with lower costs in the supportive bandage group.Methods and analysisThe SUSPECT study is an open-labelled multicentre randomised controlled trial with non-inferiority design. A total of 180 adult patients with a clinically suspected scaphoid fracture and normal initial radiographs are randomised between two groups: 3 days of supportive bandage or 2 weeks of below-elbow cast. We aim to evaluate the functional outcome and cost-effectiveness of both treatments. The primary outcome is the functional outcome after 3 months, assessed with the Quick Disability of the Arm, Shoulder and Hand score. Secondary outcomes include functional outcome, recovery of function, pain, patient satisfaction, quality of life and cost-effectiveness measured by medical consumption, absence from work or decreased productivity.Ethics and disseminationThe Medical Ethics Committee of the Erasmus MC Medical Centre, Rotterdam, approved the study protocol (MEC-2017-504). We plan to present the results after completion of the study at (inter)national conferences and publish in general peer-reviewed journals.Trial registration numberNL6976.

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Section: Methods and Analysismentioning

confidence: 99%

Clinically SUspected ScaPhoid fracturE: treatment with supportive bandage or CasT? ‘Study protocol of a multicenter randomized controlled trial’ (SUSPECT study)

et al. 2020

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“…The procedure followed was based on the guidelines suggested by different authors. 23–25 The ranges of the metacarpophalangeal and interphalangeal joints of the digits were used to calculate total active motion.…”

Section: Methodsmentioning

confidence: 99%

Pathomechanics of the wrist following fractures of the distal radius

Mifsud

Drew

2015

Hand Therapy

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Introduction: The wrist positions the hand in space and allows load transmission from the hand to the forearm. This research study aimed to explain the biomechanical changes that occur at the wrist following a fracture of the distal radius and to explore the effect of this fracture on wrist and hand range of motion and muscle strength. It was hypothesised that a fracture of the distal radius interferes with the biomechanical integrity of the wrist limiting the available wrist and hand range of motion. This in turn affects hand muscle strength. Methods: This prospective research study adopted a quantitative quasi-experimental time-series design where 109 patients followed an occupational therapy programme for 12 weeks. Measurements of forearm, wrist and hand range of motion and hand muscle strength were taken on the initial assessment, and on the 6th and 12th weeks of intervention. A standard evaluation procedure was followed to ensure reliability of the results. Data were analysed using SPSS (PASW version 18). Results: Forearm and wrist range of motion and muscle strength were significantly impaired. Hand range of motion was also affected even though the hand itself was not directly involved in the injury. Improvements in range of motion were accompanied by an increase in hand muscle strength. Patients with intra-articular fractures experienced greater limitations compared to their counterparts. Conclusions: These results supported the initial hypothesis. Clinically, this highlights the need for orthopaedic management and rehabilitation to be based on a sound knowledge of the biomechanical interaction of the different structures involved.

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“…1,5 Injuries to the ECU can occur in conjunction with other structures, such as the TFCC, or independently. 6 Given its anatomical makeup and contribution to function, injury to the TFCC may impact ECU tendon function and DRUJ stability. 2 The distal ulna comprises 20% of the axial load of the forearm; therefore, disruption of the TFCC compromises the stability of the distal ulna, which in turn reduces the force transmitted through the distal ulna and may affect the function and performance of the ECU tendon.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] Extensor carpi ulnaris tendinopathy is a common source of pain and dysfunction in athletes who perform repetitive "snapping" motions and axial-loading of the forearm and wrist. 2,6 The ECU is susceptible to injury, instability, and tendinopathy, when the forearm encounters an unexpected rotational force with twisting motions, such as the combination of hypersupination and wrist flexion motions, as seen in stick sports. 6 Repetitive forearm rotation may also stress the ECU subsheath, predisposing it to injury.…”

Section: Introductionmentioning

confidence: 99%

Extensor Carpi Ulnaris Tendinopathy in Athletes: A Review of the Conservative and Rehabilitative Options

Zarro

Bickhart

May

et al. 2022

Hand (New York, N,Y.)

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Background: Extensor carpi ulnaris (ECU) tendinopathy is characterized by pain along the dorsal and ulnar aspect of the wrist and distal forearm. It is common in athletes who play stick and racquet sports due to repetitive motion and axial-loading through the wrist and forearm. Conservative therapeutic options include rest, the use of anti-inflammatory medications, and various injections. Rehabilitation via occupational or physical therapy includes therapeutic exercise, splinting, activity modification, manual therapy, and modalities. Methods: A narrative review of the literature on ECU tendinopathy is presented, and a case study approach is used to highlight the clinical management of this condition in an elite athlete. Results: An approach of medical management and rehabilitation allowed this patient to successfully return to play. Conclusions: A combination of conservative measures and rehabilitation can be used to treat ECU tendinopathy and permit patients to be symptom-free and return to their desired activities.

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Clinical Examination of the Wrist

Cited by 8 publications

References 68 publications

Clinically SUspected ScaPhoid fracturE: treatment with supportive bandage or CasT? ‘Study protocol of a multicenter randomized controlled trial’ (SUSPECT study)

Clinically SUspected ScaPhoid fracturE: treatment with supportive bandage or CasT? ‘Study protocol of a multicenter randomized controlled trial’ (SUSPECT study)

Pathomechanics of the wrist following fractures of the distal radius

Extensor Carpi Ulnaris Tendinopathy in Athletes: A Review of the Conservative and Rehabilitative Options

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