Rehabilitation of the Hand and Upper Extremity, 2-Volume Set

7th Edition - January 14, 2020
Authors: Terri M. Skirven, A. Lee Osterman, Jane Fedorczyk, Peter C. Amadio, Sheri Felder, Eon K Shin
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 5 0 9 1 3 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 5 4 7 1 5 - 4

Long recognized as an essential reference for therapists and surgeons treating the hand and the upper extremity, Rehabilitation of the Hand and Upper Extremity helps you return… Read more

Rehabilitation of the Hand and Upper Extremity, 2-Volume Set

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Long recognized as an essential reference for therapists and surgeons treating the hand and the upper extremity, Rehabilitation of the Hand and Upper Extremity helps you return your patients to optimal function of the hand, wrist, elbow, arm, and shoulder. Leading hand surgeons and hand therapists detail the pathophysiology, diagnosis, and management of virtually any disorder you’re likely to see, with a focus on evidence-based and efficient patient care. Extensively referenced and abundantly illustrated, the 7th Edition of this reference is a "must read" for surgeons interested in the upper extremity, hand therapists from physical therapy or occupational therapy backgrounds, anyone preparing for the CHT examination, and all hand therapy clinics.

Instructions for online access
Cover image
Title page
Table of Contents
Copyright
Dedication
Seventh Edition Editors
Contributors
Foreword
Preface
Volume One
Part 1. Anatomy and Biomechanics
1. Anatomy and Kinesiology of the Hand
Osteology of the Hand
Articulations of the Hand
Skin, Retinacular System, and Compartmentation of the Hand
Intrinsic Muscles of the Hand
Tendons of the Extrinsic Muscles of the Hand
Digital Balance
Nerve Supply of the Hand
Blood Supply of the Hand
2. Anatomy and Kinesiology of the Wrist
Bony Anatomy
Joint Anatomy
Ligament Anatomy
Tendons
Vascular Anatomy
Wrist Innervation
Kinematics
Kinetics
Summary
3. Anatomy and Biomechanics of the Elbow
Biomechanics
Anatomy
Summary
4. Anatomy and Kinesiology of the Shoulder
Range of Motion
Glenohumeral Anatomy
Glenohumeral Biomechanics
Acromioclavicular Joint
Biomechanics of the Shoulder Complex
Summary
Part 2. Examination
5. Clinical Examination of the Hand
History
Physical Examination
Nerve Supply of the Hand—Motor and Sensory
Vascularity of the Hand
Medical Screening and Review of Systems
Summary
6. Clinical Examination of the Wrist
History of the Injury or Onset
Inspection of the Wrist
Objective Assessments
Diagnostic Injection
Diagnostic Ultrasound
Physical Examination
General Tests
Self-Report Measures
Summary
7. Clinical Examination of the Elbow
Introduction
Examination
Considerations for Special Populations
Interview: History and Systems Review
Physical Examination
Examination Procedures
Common Conditions Affecting the Elbow
8. Clinical Examination of the Shoulder
Patient Characteristics
Postoperative Evaluation
Physical Examination
Summary
Summary
9. Upper-Quarter Screen
Inspection
Cervical Spine
Joint Scan
Myotome Scan
Sensory Scan
Palpation
Deep Tendon Reflexes
Summary
10. Sensibility Testing
Theoretical Basis for Sensibility Testing
Pathophysiology of Nerve Disorders
Sensibility Testing in Practice
11. Functional Tests for Dexterity
Psychometric Properties
Functional Assessment Instruments
Functional Assessment of Hand Strength
Functional Assessment of Sensation
Functional Assessment of Activity of Daily Living and Instrumental Activity of Daily Living Performance
Functional Assessment of Work Performance
Functional Assessment of Manual Dexterity and Coordination
Summary
12. Diagnostic Imaging of the Upper Extremity
Imaging Modalities
Imaging of Shoulder Pathology
Imaging of Elbow Pathology
Imaging of Hand and Wrist Pathology
Summary
13. Electrophysiological Evaluation
Clinical Assessment
Overview
Nerve Conduction Study
Pathophysiology
Proximal Nerve Lesions
Electromyography
Healthy Muscle
Pathology
Nerve Recovery
Clinical Considerations
14. Clinical Interpretation of Patient Self-Report Measures and Diagnostic Accuracy of Provocative Tests
Introduction
Patient-Reported Outcome Measures
Diagnostic Testing for the Upper Extremity
Study Design
Clinical Usefulness
Conclusion
Part 3. Skin/Soft Tissue Conditions
15. Soft Tissue Healing: The Basis of Intervention
Soft Tissue Matrix
Regeneration or Repair
Repair Sequence
Conclusion
16. Wound Classification and Management
Layers of the Skin (FIG. 16.1)
Wound Healing Phases
Assessing A Wound
Assessment and Staging of Burns
Goals of Wound Healing and Product Selection
Types of Debridement
Skin Grafts
Management of Skin Grafts and Skin Substitutes
Additional Wound Therapies
Edema Management in Wounds
Scar Assessment and Management
Considerations and Conditions Associated with Hand Wounds
Conclusion
17. Common Infections of the Hand
General Considerations
Anatomy
Diagnosis
Classification
Principles of Management
Types of Infections
Common Sources of Infection
Summary
18. Surgery Management of Dupuytren’s Disease
Description and Presentation
Historical Review
Basic Science
Pertinent Anatomy
Pathoanatomy
Indications for Treatment
Types of Surgery
Authors’ Preferred Treatment Method
Complications
Postoperative Management and Hand Therapy
Results of Treatment
Summary
19. Therapy Management of Dupuytren’s Contracture
Introduction
Description
Nonoperative Treatments
Postoperative Therapy and Orthotic Intervention
The Value of Preoperative Therapy
Postoperative Management: Author’s Preferred Technique
Rationale and Clinical Experience for the No-Tension Technique
Discussion
Continued Study
Summary
20. Soft Tissue Tumors of the Forearm and Hand
Assessment of Masses in the Upper Extremity
Principles of Biopsy
Tumor-Mimicking Lesions
Ganglion Cysts
Giant-Cell Tumors of the Tendon Sheath
Lipomas
Vascular Tumors
Inclusion Cysts
Nerve Tumors
Fibromatosis
Tumors of the Epithelium
Soft Tissue Sarcomas
Metastatic Disease
The Role of the Therapist
Summary
Part 4. Fractures, Joint Injuries, and Stiffness of the Hand
21. Fracture Healing: An Evolving Perspective
Fracture Healing Concepts
Fracture Healing Terminology
Fracture Healing Phases
Goals of Fracture Healing
22. Fractures: General Principles of Surgical Management
Patient Evaluation
Fracture Classification
Options for Fracture Fixation
Fracture Healing
Complications
Summary
23. Surgery Management of Extraarticular Hand Fractures
Metacarpal Shaft Fractures
Phalangeal Shaft Fractures
Complications of Metacarpal and Phalangeal Fractures
Summary
24. Therapy Management of Extraarticular Hand Fractures
Background
Early Controlled Mobilization: General Principles
Understanding the Fracture Injury: Essential Questions
Phases of Rehabilitation Based on Relative Stability
Early Controled Mobilization: Fracture-Specific Considerations
Summary
25. Intraarticular Hand Fractures and Joint Injuries: Part 1—Surgeon’s Management
Evaluation
Proximal Interphalangeal Joint
Distal Interphalangeal Joint and Thumb Interphalangeal Joint
Metacarpophalangeal Joints 2 Through 5
Carpometacarpal Joints 2 Through 5
Thumb Metacarpophalangeal Joint
Thumb Carpometacarpal Joint
Future Directions
Summary
26. Intraarticular Hand Fractures and Joint Injuries: Part 2—Therapy Management
Overview
Guiding Principles for Evaluation
Guiding Principles for Treatment
The Late Referral
Summary
27. Pathophysiology and Surgical Management of the Stiff Hand; Postoperative Management of Metacarpophalangeal Joint and Proximal Interphalangeal Joint Capsulectomies
Introduction
Anatomy of the Metacarpophalangeal Joint
Anatomy of the Proximal Interphalangeal Joint
Preventing the Stiff Hand
Characteristics of Stiffness of the Hand
Stiffness of the Hand Intrinsics
Thumb Stiffness
Hand Stiffness Associated with Diabetes
Preoperative Assessment and Surgical Management of Stiffness of the Hand
Surgical Management of Metacarpophalangeal Joint Extension Contractures
Surgical Management of Metacarpophalangeal Joint Flexion Contractures
Hand Therapy
Results
Case Report
Summary
28. Therapist’s Management of the Stiff Hand
The Challenge of the Stiff Hand
Understanding Joint Stiffness
Motor Cortex Repatterning
Prevention of Joint Stiffness
Factors Contributing to Joint Stiffness
Traumatic and Fibroproliferative Conditions
Edema
Evaluation of the Stiff Hand
Muscle Isolation and Pattern of Motion
Wrist Tenodesis Pattern
Outcome Measures
Treatment of the Stiff Hand
Clinical Reasoning and Treatment Implementation
Home Exercise Programs
Use of Orthotic Mobilization
Types of Mobilization Orthoses
Active Redirection Orthosis
Clinical Application of Casting Motion to Mobilize Stiffness
General Principles
Treatment Guidelines
Summary
Part 5. Tendon Injuries of the Hand and Wrist
29. Advances in Understanding of Tendon Healing and Repairs and Impact on Postoperative Management
Significance of Tendon Injuries
Pharmacologic Manipulation of Tendon Healing
Tendon Lubrication: Hyaluronic Acid and Lubricin
Engineering the Tendon Surface
30. Surgery Management of Flexor Tendon Injuries
Anatomy
Biomechanics of Tendon Repair Strength
Gliding Resistance and Repair Strengths of the Tendon During Digital Motion
Clinical Diagnosis
Surgical Techniques of Primary and Delayed Primary Repairs
Essential Features of a Strong Tendon Repair
Venting of the Critical Pulleys
Wide-Awake Flexor Tendon Repair: how we do it
Wide-Awake Approach and Intraoperative Testing of Repair Quality
Our Preferred Rehabilitation Regimen
Tenolysis
Secondary Grafting or Reconstruction
31. Therapy Management of Flexor Tendon Injuries and Repairs
Surgical Information
Tendon Repair Strength versus Light Active Flexion
Postoperative Therapy
Postoperative Therapy: Program Options
Postoperative Therapy: Edema Control
Postoperative Therapy: Orthoses
Postoperative Therapy: Specific Exercises
Postoperative Therapy: Progression of Exercise
Lessons Learned: Clinical Experience
Ruptures
Outcomes (Two-, Four-, Six-, and Eight-Strand Repairs; Buttons; and Anchors)
Flexor Tendon Studies: Past and Present
Summary
32. Surgical Management of Extensor Tendon Injuries
Dorsal Fascia
Wrist Extensor Tendons
Finger Extensor Tendons
Extensor Tendon Injuries About the Metacarpophalangeal Joints (Zone V)
Extensor Tendon Injuries About the Proximal Interphalangeal Joints (Zone Iii)
Extensor Tendon Injuries at the Distal Interphalangeal Joint (Zone I)
Swan-Neck Deformity
Thumb Extensor Tendons
Fractures and Extensor Tendon Deformity
Extensor Tendon Separation: Confronting the Tendon Gap
Patterns of Restraint From Scarred Extensor Tendons
33. Rehabilitation Following Extensor Tendon Injury and Repair
General Considerations
Clinical Management of Extensor Tendon Injuries by Zone
Summary
34. Secondary and Reconstructive Tendon Procedures
Patient Evaluation
Tenolysis
Direct Tendon Repair
Isolated Flexor Digitorum Profundus Injuries
Single-Stage Flexor Tendon Grafting
Two-Stage Flexor Tendon Reconstruction
The Modified Paneva-Holevich Technique
Pulley Reconstruction
Tendon Transfers
Outcomes
Summary
Part 6. Tendinopathies of the Upper Extremity
35. Management of Hand and Wrist Tendinopathies
Stenosing Tendovaginitis
Insertional Tendinopathies
Tenosynovitis Associated with Systemic Disorders and Infection
Congenital Trigger Digit
Summary
36. Therapy Management of Lateral Elbow Tendinopathy
Introduction
Anatomical Characteristics
Pathophysiology
Differential Diagnoses
Clinical Presentation
Management Strategies
Summary
37. Surgical Management of Lateral Elbow Tendinopathy
Introduction
Summary
38. Rotator Cuff Tendinopathies and Tears: Surgery and Therapy
Anatomy
Biomechanics
Pathogenesis of Rotator Cuff Disease
History and Physical Examination
Imaging
Natural History
Nonoperative Management
Operative Intervention
Summary
39. Platelet-Rich Protein Injections
Introduction
Pathophysiology
Preparation
Basic Science
Lateral Epicondylar Tendinopathy
Rotator Cuff Syndrome
Other Tendinopathies
Conclusion
Part 7. Peripheral Nerve Injury and Restoration of Function
40. Basic Science of Peripheral Nerve Injury and Repair
Anatomy and Physiology of the Peripheral Nervous System
Classifications of Nerve Injury
Nerve Responses to Injury
Healing of Acute Nerve Injury
Chronic Nerve Injury
Nerve Repair and Graft Reconstruction
41. Therapy Management of Peripheral Nerve Injuries and Repairs
Adaptation to Injury
Presentation of Specific Nerve Injuries
Intervention
Enhancing Neural Recovery and Prehension
Case Study
Summary
42. Sensory Relearning and the Plastic Brain
The Sensational Hand: Conceptual Framework
Factors Influencing Outcome After a Nerve Injury and Sensory Relearning
Cortical Remodeling: Response to Sensory Input
Sensory Relearning: Principles and Planning
Sensory Reeducation in Phase 1: a Sensory Preparation
Sensory Relearning in Phase 2
How Brain Organization is Influenced by Sensory Relearning and Environmental Influence on Sensory Relearning
Follow-Up of Sensory Relearning
Conclusion
43. Tendon Transfers for Upper Extremity Nerve Injuries
Introduction
Radial Nerve
Median Nerve
Ulnar Nerve
Combined Median and Ulnar Nerve Palsies
Summary
44. Therapy Management of Tendon Transfers
Tendon Selection
Timing of Tendon Transfers
Preoperative Treatment
Postoperative Management
Common Transfers
Summary
45. Surgical Management of Adult Traumatic Brachial Plexus Injuries
Anatomy and Classification
Physical Examination
Imaging Studies
Electrodiagnostic Tests
General Management Principles
Surgical Intervention
Rehabilitation
Outcomes
Summary
46. Restoration of Function After Adult Brachial Plexus Injury
Introduction
Applied Anatomy of the Brachial Plexus
Mechanism of Injury
Physician Management of Brachial Plexus Injuries
Therapeutic Management of Adult Brachial Plexus Injuries
The Importance of Neuroplasticity
Measuring Outcomes
Barriers to Recovery
Summary
47. Common Nerve Injuries About the Shoulder
Introduction to Diagnosis and Management
Anatomy
Types of Nerve Injury
Physical Examination
Diagnostic Tests
Treatment
Summary
Part 8. Upper Extremity Neurogenic Pain and Compression Neuropathies
48. Basic Science of Nerve Compression
Peripheral Nerve Anatomy
Basic Neurophysiology
Classification of Nerve Injuries
Pathophysiology of Nerve Compression
Histopathology
Double-Crush Phenomenon
Effect of Joint Position and Hand Loading
Vibration Exposure
Evaluation of Nerve Compression
Summary
49. Regional Interdependence: Pain Mediation of the Cervical Spine
Incidence and Prevalence
Risk Factors
Definition and Causes
Anatomy
Patient History
Physical Examination
Intervention
Summary
50. Thoracic Outlet Syndrome
Anatomy
History
Classification
Diagnosis
Physical Examination
Diagnostic Studies
Electrodiagnostic Testing
Treatment
Results
Recurrent Thoracic Outlet Syndrome
Summary
51. Therapist’s Management of Upper Quarter Neuropathies
Major Types of Thoracic Outlet Syndrome
Incidence of Brachial Plexopathy
Diagnosis and Classification
Therapist’s Management
Therapy Intervention
Case Example
Summary
52. Surgery Management of Compression Neuropathies of the Wrist
Median Nerve
Clinical Presentation and Diagnosis
Differential Diagnosis
Conservative Management of Carpal Tunnel Syndrome
Surgical Management of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome in Pregnancy
Postoperative Management
Ulnar Nerve Compression at the Wrist
Pathogenesis
Conservative Management
Surgical Management
Radial Nerve Compression at the Wrist
Clinical Presentation and Diagnosis
Surgical Management
53. Therapists’ Management of Compression Neuropathies at the Wrist
Carpal Tunnel Syndrome
Ulnar Tunnel Syndrome
Radial Sensory Nerve Compression (Wartenberg’s Syndrome)
Summary
54. Surgery Management of Compression Neuropathies of the Elbow
Anatomy
Pathophysiology
Etiology
Phylogenic Considerations
Classification
Diagnosis
Treatment
Postoperative Care
Results
Complications
Outcomes and Prognosis
Radial Tunnel Syndrome
Anterior Interosseous Nerve–Pronator Syndrome
Summary
55. Therapy Management of Compression Neuropathies of the Elbow
History
Basic Principles of Conservative Management
Basic Principles of Postoperative Management
Specific Nerve Compression Syndromes
Summary
Part 9. Vascular and Lymphatic Disorders
56. Vascular Disorders of the Upper Extremity
Vascular Anatomy
Diagnostic Workup
Common Vascular Disorders of the Upper Extremity
Hand Surgery in Particular Populations
Summary
57. Edema Management
Edema Defined
Fluid Transport Through Blood Capillaries
Evaluation of Edema
Treatment
Summary
58. Acute Care and Rehabilitation of the Hand After Cold Injury
Introduction
Epidemiology
Summary
Part 10. Common Wrist Injuries and Conditions
59. Surgery Management of Distal Radius Fractures
Introduction
History
Epidemiology and Economic Impact
Classification and Anatomy
Clinical Evaluation
History and Physical Examination
Radiographic Evaluation
Advanced Imaging
Treatment
Postoperative Care
Conclusion
60. Therapy Management of Distal Radius Fractures
Anatomic and Kinematic Review in Relation to Rehabilitation
Hand Therapy Evaluation
Treatment
Other Relevant Evidence
Limiting Factors
Predictors
Conclusion
61. Surgery Management of the Distal Radioulnar Joint: Acute and Chronic Injuries
Introduction
History
Distal Radioulnar Joint Motion
Description of Distal Radioulnar Joint Problems
Distal Radioulnar Joint Instability
Stage of Distal Radioulnar Joint Instability
Ulnocarpal Abutment
Distal Radioulnar Joint Incongruity
Management of Distal Radioulnar Joint Problems
Technique
Postoperative Treatment
Ulna Shortening Osteotomy
Technique
Potential Pitfalls
Postoperative Care
Conclusion
62. Ulnar Wrist Pain and Impairment: A Therapist’s Algorithmic Approach to the Triangular Fibrocartilage Complex
Ulnar Wrist Pain and Impairment: the Triangular Fibrocartilage Complex and Distal Forearm
An Algorithmic Approach to the Management of Ulnar Wrist Pain and Impairment
Triangular Fibrocartilage Complex Postoperative Considerations
Other Important Treatment Principles
Summary
63. Management of Carpal Fractures and Dislocations
Objective
Carpal Fractures
Principles of Rehabilitation for Carpal Fractures and Dislocations
Summary
64. Classification and Management of Carpal Instability
Introduction
Classification
Scapholunate Dissociation
Pathomechanics
Clinical Examination
Radiographic Examination
Treatment
Lunotriquetral Dissociation
Palmar Midcarpal Instability
65. Wrist Salvage Procedures: Surgery and Therapy
Diagnosis
Total Wrist Arthrodesis
Total Wrist Arthroplasty
Distal Ulna
Radiocarpal Arthrodesis
Midcarpal Arthrodesis
Future Directions
Part 11. Common Elbow Injuries and Conditions
66. Surgery Management of Fractures, Dislocations, and Traumatic Instability of the Elbow
Fractures of the Distal Humerus
Fractures of the Capitellum and Trochlea
Fractures of the Olecranon Process
Dislocations of the Elbow
Fracture–Dislocations of the Elbow (Complex Instability)
Summary
67. Therapeutic Management of Fractures, Dislocations, Traumatic Instability, and Stiffness of the Elbow
Traumatic Elbow Injuries: Overview of Fractures, Dislocations, and Ligament Injuries
Elbow Anatomy and Biomechanics
Elbow Anatomy Contributes to Complications Associated with Traumatic Injuries
Clinical Examination
Rehabilitation Phases
Collateral Ligament Injuries and Repair
Complex Forearm and Elbow Fractures
Elbow Arthroplasty
Posttraumatic Elbow Stiffness
Summary
68. Biceps and Triceps Tendon Injuries: Surgery and Therapy
Epidemiology
Anatomy
Biomechanics
Mechanism of Injury
Classification
Diagnosis
Management
Surgical Management
Triceps Tendon Rupture
Conclusions
69. Elbow Injuries in the Throwing Athlete
Introduction
Elbow Injuries
Biomechanics of Throwing
The Kinetic Chain in Throwing
Conservative Management of Medial Elbow Pain
Ulnar Collateral Ligament Reconstruction Postoperative Rehabilitation
Volume Two
Part 12. Common Shoulder Injuries and Conditions
70. Frozen Shoulder: Surgery and Therapy
Pathology
History and Physical Examination
Radiographic Studies
Treatment
Modalities
Stretching
Joint Mobilization
Intraarticular Corticosteroid Injection
Manipulation Under Anesthesia
Arthroscopic Surgery
Proposed Intervention Algorithm
Therapy Intervention
Surgical Intervention
Summary
71. Rehabilitation of Shoulder Instability
Epidemiology
Anatomic and Biomechanical Considerations
Traumatic Instability
Atraumatic Instability
Posterior Instability
Superior Labrum Anterior–Posterior Lesions
Postoperative Rehabilitation of Capsulolabral Repair of the Shoulder
Guiding Rehabilitation Principles
Specific Rehabilitation Guideline Arthroscopic Anterior Capsulolabral Repair
Summary
72. Examination and Management of Scapular Dysfunction
Evaluation and Management of Scapular Dysfunction
Abnormal Scapular Motion (Scapular Dyskinesis)
Is scapular dyskinesis related to shoulder pathology?
Examination
Summary
Part 13. Complex Traumatic Conditions
73. Surgery Management of Complex Injuries of the Hand
Introduction
History and Physical Examination
Ancillary Studies
Treatment
Summary
74. Surgery Management for Replantation or Revascularization of the Hand
Preoperative Assessment and Management
Surgical Technique
Postoperative Therapy
Conclusion
75. Therapy Management of Complex Injuries of the Hand
Wound Healing
Healing of Specific Tissues
Overview of Treatment Techniques
Rehabilitation Guidelines for Each Phase of Healing
Summary
76. Fingertip Injuries: Surgery and Therapy
Anatomy
Surgical Considerations
Authors’ Recommendations
Therapist’s Management
Summary
77. Acute Management of Upper Extremity Amputation
Introduction
Targeted Muscle Reinnervation: Background and Rationale
Operative Technique for Targeted Muscle Reinnervation
Management of Upper Extremity Amputations by Level
Postoperative Care and Considerations
Conclusion
78. Rehabilitation of Upper Extremity Amputation and Prosthetic Training
Etiology and Classification of Upper Limb Amputations
Interdisciplinary Team Approach
Patient Evaluation
Education and Resources
Peer Support and Peer Mentor
Pain Management
Caring for the Residual Limb
Prosthetics
Partial Finger and Partial Hand Considerations
A “Prosthosis” as a Temporary Prosthesis
Essential Functions of the Hand After Partial Hand Amputation
Amputation Considerations Explored by Digit Level
Residual Limb Management After Partial Hand Amputation
Range of Motion and Strengthening Considerations
Retraining Prehension in the Partial Hand Amputee
Bilateral Upper Limb Absence Rehabilitation
Potential Complications
conclusion
79. Hand and Upper Extremity Transplantation: Surgical and Therapy Management
Medical-Surgical
Surgical Considerations
Early Postoperative Monitoring
Adult Rehabilitation Program
Adult Posttransplant Therapy
Transfers and Ambulation
Special Considerations for Pediatric Transplant Patients
Summary
80. Management of Skin Grafts and Flaps: The Surgeon’s Perspective
Introduction
Patient Assessment
Management Strategy
Summary
81. Medical and Surgical Management of Burns of the Upper Extremity
Acute Period
Reconstructive Period
Summary
82. Therapy Management of the Burned Hand and Upper Extremity
Skin Anatomy and Function
Biomechanics and Biorheology of Skin and Scar
Evaluation and Treatment
Orthotic Intervention
Serial Casting
Range of Motion
Strength, Conditioning, and Activities of Daily Living Training
Pain Management
Sensation
Scar Management
Scar Treatment
Summary
83. Psychosocial Issues After a Traumatic Upper Extremity Injury: Facilitating Adjustment
Introduction
Setting the Therapeutic Stage: Trust, Respect, Communication, and Relationship
Interdisciplinary Assessment and Planning
Psychological Responses After a Traumatic Hand Injury
Psychological Issues: Hand Therapy Intervention
Mental Health Assessment
Coping Strategies
Social Issues After a Hand Injury
The Impact of Role Change: Spouse, Caregiver, Friend, and Worker
Hand Therapy Intervention: Restoring Valued Roles and Patient-Centered Assessment
Patient-Centered Assessment
The Impact of Social Stigma and Hand Therapy Intervention
The Impact of Culture and Hand Therapy Intervention
Motivational Interviewing: Improving Motivation and Facilitating Change
Summary: Achieving Better Outcomes
Part 14. Arthritis & Related Autoimmune Disorders
84. Pathomechanics of Deformities of the Arthritic Hand and Wrist
Synovium
Tendon Ruptures
The Wrist
Metacarpophalangeal Joint Deformities
Finger Deformities
Thumb Deformities
Summary
85. The Arthritic Hand: Conservative Management
Conditions
Examination
Treatment Planning
Summary
86. Surgery and Therapy for the Rheumatoid Hand and Wrist
Introduction
The Wrist
Finger Extensor Tendon Ruptures
Thumb Extensor Tendon Rupture
Flexor Tendons
Rehabilitation Guidelines for Specific Transfers
Carpal Tunnel Syndrome
Wrist Arthritis
The Metacarpophalangeal Joint
The Proximal Interphalangeal Joint
The Distal Interphalangeal Joint
The Thumb
87. Surgery Management of the Osteoarthritic Thumb Carpometacarpal Joint
Introduction
Pathophysiology
Assessment and Diagnosis
Surgical Management: Trapezial-Sparing Procedures
Surgical Management: Trapezial-Sacrificing Procedures
Summary
88. Therapist’s Management of the Thumb Carpometacarpal Joint with Osteoarthritis
Anatomical Considerations
Biomechanical and Neuromuscular Considerations
Therapy Interventions
Occupation-Based Interventions
Measuring Outcomes
Postsurgical Management
Conclusion
89. Surgical and Postoperative Management of Shoulder Arthritis
Diagnosis
Specific Arthritides Affecting the Shoulder
Management of Shoulder Arthritides
Debridement and Capsular Release
Shoulder Hemiarthroplasty
Total Shoulder Arthroplasty
Reverse Total Shoulder Arthroplasty
Summary
90. Surgical and Postoperative Management of Elbow Arthritis
Introduction to Elbow Arthritis
Joint-Preserving Surgical Options
Joint-Replacing Surgical Options
Summary
91. Scleroderma: Surgery
History and Pathogenesis
Clinical Findings
Surgical Treatment
The Changing Paradigm of Surgery in Scleroderma
92. Scleroderma: Therapy
Epidemiology, Pathogenesis, and Classification
Medical Management
Quality of Life and Hand Function
Hand Involvement in Systemic Sclerosis
Hand Rehabilitation
Assessment
Interventions
Surgery
Summary
Part 15. Hand and Upper Extremity Pain
93. Understanding Pain Mechanisms: The Basis of Clinical Decision Making for Pain Modulation
Introduction: Acute Versus Persistent Pain
Neuroanatomical Basis of Somatic Pain: Peripheral Mechanisms
Neuroanatomical Basis of Pain in the Head and Neck: Peripheral Mechanisms
Peripheral Sensitization: Mechanisms
Physiologic Basis of Pain: Central Mechanisms
Central Sensitization: Mechanisms
Summary
94. Pain Assessment
Clinical Assessment of Pain
Identifying the Dominant Driver
Assessing Risk for Development of Persistent Pain
95. Medical Management for Pain
Historical Perspective on Medical Pain Management
Pain Classifications
Functional Classification
Temporal Classifications
Types of Medications for Pain Management
Current Concepts and Controversies in Medical Management
96. Pain Management: Principles of Therapist’s Interventions
Introduction: Challenges of Pain Treatment
Interventions for Pain Management
Choosing the Best Interventions for Your Patient
Summary
97. Complex Regional Pain Syndromes: Types 1 and 2
Demographics
Diagnosis
Treatment
Summary
98. Therapists’ Management of Complex Regional Pain Syndrome
Evaluations to Inform Diagnosis
Evidence-Informed Rehabilitation Interventions for Complex Regional Pain Syndrome
Summary
Part 16. Therapy Techniques
99. Proprioception in Hand Rehabilitation
Introduction
Mechanoreceptors
Innervation of Joints in the Human Hand
Supraspinal Control
Ligamentomuscular Reflexes
Proprioception Rehabilitation: Theory and Practice
Early Rehabilitation Phase (Hagert Stages 1–4)
Late Rehabilitation Phase (Hagert Stages 5 And 6)
Neuromuscular Reeducation Applied in Practice
Scapholunate Instability
Lunotriquetral Instability
Midcarpal Instability
Distal Radioulnar Joint Instability
Wrist Fractures
100. Graded Motor Imagery
Background
Graded Motor Imagery Phases
Pain and Graded Motor Imagery
Conclusion
101. The Use of Physical Agents in Hand Rehabilitation
Thermal Agents
Electrotherapy
Iontophoresis and Phonophoresis
Low-Level Laser Therapy
Clinical Applications for Physical Agents
Summary
102. Neurodynamic Treatment, Examination, and Intervention with Nerve Gliding
Neuropathic Pain
Biomechanical and Physiologic Concepts
Neuropathology and its Manifestations
Neurodynamic Testing and Neurodynamic Intervention Research
Practical Approach to Neurodynamic Testing and Neurodynamic Intervention
Summary
103. Taping Techniques
Introduction to Therapeutic Taping
Elastic Tape Introduction
Theoretical Clinical Benefits and Evidence for Elastic Tape Application
Theoretical Benefits of Elastic Tape for Improved Blood and Lymphatic Circulation
Appendix A: Elastic Tape Application
Appendix B: Rigid Tape Application
104. Manual Therapy in the Management of Upper Extremity Musculoskeletal Disorders
Introduction
Mechanisms of Manual Therapy
Efficacy of Manual Therapy
The Selection of Technique
Mobilization with Movement
Summary
105. Optimizing Outcomes: Concepts of Patient Preference, Health Literacy, and Adherence to Treatment
Concepts
The Continuum of Literacy to Adherence
Modifiers of Adherence
Measures of Adherence
Operationalizing Adherence in Clinical Practice
Part 17. Orthotic Intervention-Principles and Techniques
106. Client-Centered, Bio-occupational Framework for Orthotic Intervention
Introduction to the Framework
Shelley’s Story
What is an Orthosis?
Using a Bio-Occupational Lens
Principles of the Framework
Principle 1. Ensure Client-Centeredness
Jim’s Story
Principle 2. Identify and Address Biological Goals and Minimize Biological Harm
Samuel’s Story
Summary: Achieving Better Outcomes
107. Relative Motion Orthoses: The Concepts and Application to Hand Therapy Management of Finger Extensor Tendon Zone III and VII Repairs, Acute and Chronic Boutonnière Deformity, and Sagittal Band Injury
Relative Motion: the Metacarpophalangeal Joint and the “Quadriga Effect”
Relative Motion Extension
Chronic Sagittal Band Injury and Ruptures
Relative Motion Flexion
Summary
108. Orthoses for Mobilization of Joints: Principles and Methods
Objectives of Mobilization Orthoses
Classification of Mobilization Orthoses
Assessment
Physiologic Factors
Principles of Using Mobilization Orthoses
Conclusion
109. Tissue Remodeling and Contracture Correction Using Serial Casting and Orthotic Intervention
Pathomechanics: the Inevitability of Gradualness
Growth, not Stretch
Indications for Serial Plaster Casting or Orthotic Positioning
Advantages of Casting for Tissue Remodeling
Contraindications for Serial Plaster Casting or Orthotic Positioning
Serial Cylindrical Casting Method: Plaster of Paris
Skin Tolerance
Distal Interphalangeal Joint Inclusion and Exclusion
Serial Cylindrical Casting Method with Fabric-Based Thermoplastic Tapes
Helpful Techniques for Finger Casting
Removable Cylinder Casts
Plaster Casting for Dorsal Proximal Interphalangeal Joint Wounds or Webbed Fingers
Casting for Correction of More than one Joint in two Planes of Movement: Flexion and Extension
Elastic Tension Digital Neoprene Orthosis
Circumferential Thermoplastic Tube Orthosis
Casting with Softcast
Casting of Other Joints and Muscle–Tendon Units
Strategic Casting of a Chronically Stiff Hand
Measurement and Documentation of Change
Summary
110. Soft Orthoses: Indications and Techniques
Common Conditions for Soft Orthoses
Fabrication of a Thumb Neoprene Abduction Orthosis for Flexor Tone without Sewing
Summary
Part 18. Unique Patient Populations
111. Therapy Management of the Upper Extremity Poststroke: Understanding the Mechanisms of Motor Recovery
Introduction to Stroke and Motor Recovery
Common Deficits Affecting Upper Extremity Motor Performance
Foundational Knowledge of Motor Rehabilitation
Evaluation of the Upper Extremity After Stroke
Intervention Methods Addressing Motor Recovery After Stroke
Emerging Treatments
Summary
Conclusion
112. Hemiplegia: Operative Management
Indications and Goals of Surgery
Shoulder: Deformity and Associated Problems
Elbow: Deformity and Associated Problems
Forearm and Wrist: Deformity and Associated Problems
Hand Deformities and Associated Problems
Thumb: Deformity and Associated Problems
Summary
113. Rehabilitation of the Hand and Upper Extremity in Tetraplegia
Introduction
The Scope of the Problem
Pathophysiology
Patient Evaluation
Principles of Nonoperative Management
Orthotic Positioning and Orthoses
PharmAcotherapy and Contractures
Role of Electrical Stimulation
Principles of Surgical Reconstruction
Treating Each Patient Individually
Special Considerations for Children and Adolescents
General Surgical Techniques
General Tendon Transfer Management
General Therapy Guidelines After Nerve Transfers
General Neuroprosthetic Implantation Therapy
Outcomes
Conclusions
114. Management of the Injured Athlete
Common Injuries in Sports
Trending Topics
Multidisciplinary Approach
Functional Assessments
Rehabilitation Techniques
Orthotic Intervention, Taping, and Bracing
Summary
115. Clinical Conditions in Patients with Breast Cancer
Introduction
Breast Cancer Treatment
Upper Body Morbidity
Cancer-Related Fatigue
116. Focal Hand Dystonia
Introduction
Definition and Classification of Focal Dystonia
Etiology of Focal Hand Dystonia
Clinical Presentation: Focal Hand Dystonia
Ruling in the Clinical Diagnosis of Focal Hand Dystonia
Treatment for Focal Hand Dystonia
Clinical Evidence-Based Research: Effectiveness of Behavioral Training
Recommendations for Research
Summary
117. Assessment and Treatment Principles for the Upper Extremities of Instrumental Musicians
Performance-Related Issues
Nonmusical Activities and Factors
118. Psychosocial Aspects of Arm Health
Introduction
Depression, Catastrophic Thinking, and Health Anxiety
Secondary Gain
Puzzling or Disproportionate Symptoms or Limitations
The Psychology of the Clinician
The Psychology of the Patient
Working with Other Experts
Patient Activation
Effective Communication Strategies
Assessment and Treatment
Summary
Part 19. The Injured Worker
119. The Injured Worker: Onsite Evaluation and Services
Introduction
Musculoskeletal Disorders
Risk and Job Hazard Assessment Tools
Job Analysis and Job Descriptions: The Challenge of Gathering Job Information
Systems, Personnel, and the Injured Worker: Coordinating Efforts to Influence Success at Work or Return to Work
Ergonomics
Office Ergonomic Data for Workstation Setup
Summary
120. Work Performance: Clinic-Based Assessment and Intervention
Understanding the Referral Question
Understanding the Patient’s Current and Past Medical History
Understanding the Patient’s Job
Employment Policies to Consider When Addressing Work
Issues Specific to the Workers’ Compensation Population
Choosing Constructs to Evaluate
Choosing Assessments to Evaluate Targeted Constructs
Screening and Assessments Regarding Work
Job-Simulated Testing of Work Activities and Occupations
Work Evaluation and job Simulation Case Example
Performance Skill and Body Function Level Assessments to Evaluate Work
Functional Capacity Evaluations
Interventions to Address Work
Work Hardening and Work Conditioning
Return-To-Work Schedules
Summary
Case Study
Part 20. The Pediatric Patient
121. Rehabilitation Considerations for the Pediatric Client
The Pediatric Client
Range of Motion
Strength
Dexterity
Functional Assessment
Sensibility
Orthosis Considerations
Adaptations
122. Management of Congenital Hand Anomalies
Introduction
Incidence and Initial Interaction With The Patient
Upper Limb Congenital Anomalies
Specific Congenital Upper Limb Anomalies (Using The Oberg-Manske-Tonkin Classification)
123. Upper Extremity Musculoskeletal Surgery in the Child with Cerebral Palsy: Surgical Options and Rehabilitation
Evaluation
Operative Procedures
Thumb and Finger Deformities
General Postoperative Care
Summary
124. Pediatric Upper Extremity Trauma
Introduction
Salter-Harris Classification
Common Pediatric Fractures
125. Brachial Plexus Birth Palsy: Secondary Procedures to Enhance Function
Classification
Patient Evaluation
Ancillary Studies
Shoulder
Scapular Winging
Elbow
Forearm
Wrist and Hand
Conservative Versus Surgical Intervention
Contracture Development
Reconstruction Options
Summary
Index

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Terri M. Skirven

A. Lee Osterman

Jane Fedorczyk

Peter C. Amadio