Pre-Conference Institutes (2-Hour)
The Peripheral Nervous System: Interactive Dissection with a Surgeon/Therapist Team
This interactive dissection will feature a local surgeon-therapist team working through the peripheral nervous system on a cadaver to identify structures, pathways, potential compression sites and relevant anatomy in commonly injured but very important upper extremity nervous distributions. You will have the opportunity to ask questions and tie in clinical implications during the live dissection which will also include demonstrations of nerve repairs and nerve transfers.
- Identify major anatomical landmarks for locating structures including the brachial plexus roots and trunks, and major peripheral nerve pathways in the upper extremity including common areas of compression.
- Locate 3 major nerve pathways originating in the brachial plexus and trace them distally through the arm into the wrist and hand.
- Describe concepts of nerve repair and nerve transfer surgery with implications for rehabilitation.
What Should I Do With this Hand?? Clinical Reasoning for the Treatment of the Stiff Hand
Your patient walks into the clinic with her hand still bandaged, no splint or cast. You learn that she is 6 weeks post ORIF volar plate after a wrist fracture. Her wrist and forearm sit in flexion and pronation, MCP’s in fixed extension, IP’s flexed, and thumb in adduction. She has limited active digit, wrist, and forearm motion. Where do you begin? The hand therapist’s primary goal in treating the post-traumatic and post-surgical hand is to restore joint mobility, tissue length and glide, so that functional hand use can be restored. In the case of the stiff, fibrotic, or contracted hand, even the most seasoned therapist is challenged. The tools available from the therapy toolbox remain consistent regardless of the diagnosis. The skill comes in being able to properly assess the concomitant problems of the stiff hand and to assimilate the information gathered using tissue healing stages to guide clinical reasoning for difficult cases. This short course is geared to intermediate-level therapists who have a working knowledge of diagnoses that can result in a stiff hand, who have some experience treating hand trauma, and who want to take their clinical practice to the next level. The course format will be lecture, combined with interactive video case discussions and a practice assessment lab. The lab component will focus on skills needed to differentiate between joint stiffness, soft tissue tightness, weakness and muscle guarding with pain and apprehension- and usually a combination of all of these. Good assessment skills are the foundation of developing an effective treatment plan that addresses the patient's greatest needs to restore function.
- Describe how the stages of tissue healing guide treatment of the stiff hand.
- Differentiate between joint stiffness, soft tissue length deficits, and the patient’s ability to recruit specific muscles for movement and function.
- Develop a comprehensive treatment plan for a patient with a stiff hand that addresses ROM, strength and functional use of the upper extremity.
- Integrate appropriate treatment priorities into your patient’s daily routine to improve knowledge, carryover and success in achieving patient goals.