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Hi
I am seeing a patient who suffered a wrist fracture (fractured her radius). All her wrist movements have pretty much returned except for wrist extension, which is at 44 degrees AROM & 61 degrees PROM. I have been doing traction, ventral glides (mobilisations) and stretching into wrist extension, but can't seem to get more wrist extension.
Any suggestions for what else I could be doing with this patient?
Thanks very much in advance!
well,
Since how long yours patinet suffered that............any other complications,...........,age ,nature of his job,....
what about end feel of the wrist,x-ray findings,how long have u been treated the patinet,.......:cool::o
depending on age, contralateral range etc 61 degrees might not be too bad? if so its the active movement thats the problem not the passive so she should be working on strengthening particularly in the range that she is weakest ie past 45 degrees of extension. use isometrics in her weak range. active assisted through full range. maybe consider e-stim to help her achieve through range active (assisted) movement.
btw junior physiotherapist, hello! that green writing is really difficult to read. maybe you would consider another colour?!
Thanks for your help!
My patient is a 43-year old stay-at-home mom. She was in a cast for 6 weeks and had it removed about 4 weeks ago.
The endfeel of her wrist extension is a tissue stretch and I have been giving her active-assisted wrist extension to try to increase the range.
Roycar -- Should I begin strengthening as you suggested at her end-range of acive wrist extension (45 degrees). Shouldn't I wait to begin strengthening until she re-gains full range of wrist extension? Or would isometrics be safe to do?
Thanks again!
Well, the findings seems there would be a good prognosis,,,
Try with yours patinet hold-relax-hold [ to be gentle with here],
As a rule in Physiotherapy we should stretch then strenght the muscles,
What about sensory tests!!!! vascularity of that area,past patinet history!!:cool::rolleyes: