Early Controlled Mobilization of Hand Fractures – Lynne Feehan, PhD, PT, CHT
Traditionally mobilization of hand fractures has been defined based on the concept a clinically stable fracture as one that can tolerate active motion, whereas, a clinically unstable fracture requires immobilization. This workshop presents an alternative view of rehabilitation progression, defining a fracture’s current structural strength as falling somewhere along a continuum of ‘relative stability’ throughout recovery. This alternative view leads to a number of graduated-motion, external protection, and functional reactivation rehabilitation options. These are based on the current structural strength or relative stability of a fracture in any individual patient at any given point in time during healing and recovery. Following the same principles used when designing, implementing, and progressing through an individualized early controlled mobilization rehabilitation plan after any fragile healing hand soft tissue injury (e.g., a tendon, ligament, or nerve injury), starting within a few days of the injury.
This 3½ hour action-packed, interactive, workshop is intended for experienced hand therapists. Therapists will work together in small groups in real clinic time to apply the principles of early controlled mobilization (ECM) to case-studies for the most common (metacarpal) and more complex (proximal phalangeal) hand fracture injuries. This workshop will provide limited time for didactic lecture and more time for small group hands-on activities.
Relative Motion Extension and Flexion: Concepts and Clinical Use – Julianne W. Howell, PT, MS, CHT
Interactive learning is the intent of this workshop by way of instruction, dialogue, and fabrication of orthotics. Juli has had been using the Concept of Relative Motion Extension (RME) following extensor zones 4-7 tendon repair for over 30 years. The RME Concept has remained the same, however the clinical details for the extensor tendon management continues to evolve and the use of the RME splints has expended to other diagnoses such as acute and chronic sagittal band rupture,
caput ulnar syndrome, nerve repair, re-balancing active motion and digital joint stiffness.
The basis for the Relative Motion Flexion (RMF) Concept to manage chronic and acute boutonniere deformities and as well as flexor tendon repair will be introduced. Guidelines for use of RMF for the above conditions will be described. Review of the literature and anatomy are heavily emphasized in this course. Case studies brought by the attendee are welcomed and will be openly discussed. Sufficient time will be dedicated to practice fabrication of RME and RMF orthotics.