Fracture Rehabilitation for Shoulder, Elbow, Wrist, Hand

Hand therapy plays a critical role in the management and rehabilitation of hand fractures. The goals of hand therapy for fracture management include promoting healing, preventing complications, restoring range of motion, improving strength and function, and facilitating a safe return to activities. Here are some key components of hand therapy for fracture management which our therapists at CARe practice:

1. Immobilization: Following a hand fracture, the hand therapist may fabricate a custom splint or provide a prefabricated one to immobilize and protect the fractured bones. The splint helps to maintain proper alignment, reduce pain, and allow for the initial stages of healing.

2. Edema and Pain Management: Hand therapists employ various techniques to manage edema (swelling) and pain associated with hand fractures. These may include elevation, compression therapy, manual lymphatic drainage, modalities such as contrast baths, cold or heat therapy, electrical stimulation, or ultrasound.

3. Range of Motion Exercises: Once the initial healing phase is complete, hand therapists introduce gentle and controlled range of motion exercises. These exercises aim to prevent stiffness and promote the restoration of normal joint mobility. The therapist guides patients through exercises that target specific joints and provide appropriate resistance to aid in joint movement.

4. Strengthening Exercises: As the fracture heals and range of motion improves, hand therapists prescribe strengthening exercises to restore muscle strength and functional abilities. These exercises may involve resistance training using therapy putty, hand grippers, or therapeutic equipment designed to target specific muscles and movements.

5. Scar Management: Hand therapists address any scar tissue that may form during the healing process. Techniques such as scar massage, manual therapy, and the use of specialized scar management products help minimize scar adhesions and improve tissue mobility.

6. Activity-Specific Training: Hand therapists assess the patient's functional goals and work with them to develop an activity-specific training program. This may involve simulating work-related tasks, sports-specific movements, or activities of daily living to improve coordination, dexterity, and strength required for specific activities.

7. Customized Splinting: In some cases, custom splints or orthoses may be utilized during the rehabilitation process to protect the hand, maintain joint alignment, or facilitate functional movements. Hand therapists can fabricate and modify splints based on the individual's needs.

8. Patient Education: Hand therapists provide education on precautions, activity modifications, and home exercise programs to ensure proper self-management. They educate patients about the signs of complications, such as infection or impaired healing, and provide guidance on when to seek medical attention.

It is important to note that hand therapy for fracture management is tailored to each patient's specific fracture type, location, and individual needs. Close collaboration between the hand therapist, orthopedic surgeon, and other members of the healthcare team ensures an effective and comprehensive rehabilitation plan.

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Sources:

1. American Society of Hand Therapists (ASHT)​

2. American Physical Therapy Association (APTA)​

3. PubMed​

4. Mayo Clinic​

5. OrthoInfo (American Academy of Orthopaedic Surgeons)​