47 Questions
What is the primary reason for choosing joint positions during treatment?
To reduce the possibility of tightening of joint ligaments
Immobilization in a splint or cast for 3-4 weeks is appropriate for all patients.
False
What is the benefit of using immobilization in zone 1/2 injuries?
Cheaper and easier to implement
Flexor tendon zones 1 and 3 have a lot of ______________ issue.
soft tissue
What is a characteristic of extensor tendon zones 1 and 2?
They have annular ligaments
Nutrients are provided to tendons directly through blood vessels.
True
Match the following flexor tendon zones with their characteristics:
Zone 1 = Mobilization, only isolate DIP Zone 2 = Annular ligaments (A1,A2,A4) - lacera=on = worse adhesions, reduced ROM Zone 3 and 4, 5 and 6, 7 and 8 = Early active protocols
What is the purpose of immobilization in the treatment of flexor tendon injuries?
To reduce the possibility of tightening of joint ligaments and create a favorable environment for tendon healing
What is the primary goal of mobilization during the immediate (early) passive phase of tendon repair?
To create glide of the repaired tendon
The two-strand suture technique is commonly used in immobilization.
False
What is the benefit of movement of the tendon within the tendon sheath during mobilization?
Assisting with nutrient diffusion into the tendon from the synovial fluid
The repaired tendon can be mobilized using the _______________ technique, which requires a high level of therapist skill.
two-strand suture
Match the following immobilization techniques with their characteristics:
Mobilization = Uses other hand or rubber bands Two-strand suture = Requires high level of therapist skill and Expensive and tolerated if infection
Immobilization is typically used for 6-8 weeks during tendon repair.
True
What is the primary purpose of immobilization in orthoses?
To restrict unwanted motion
Splints can melt if left on the dashboard of a car.
True
What is the purpose of using low temperature thermoplastics in splinting?
Primary resource
The American Society of Hand Therapists provides guidelines for _______________ in orthoses.
written instructions
Match the following splinting materials with their characteristics:
Low temperature thermoplastics = Primary resource Plaster of Paris = Supportive Neoprene = Flexible Leather = Durable
What is the purpose of restricting unwanted motion in orthoses?
To prevent contractures
What is a common complication of splinting during inflammation?
Swelling
Splints can be used to mobilize the injured joint.
False
The purpose of splinting during inflammation is to _______________ the injured tissues.
support
What is a crucial consideration in skin integrity management when using splints?
Assessing skin integrity
What is the primary purpose of immobilization in orthoses?
To support a painful joint
Immobilization in a splint or cast for 3-4 weeks is appropriate for all patients.
False
What is a common complication of splinting during inflammation?
Inflammation and swelling
Low temperature thermoplastics are a primary resource for creating splints because they can be molded to fit the patient's ______________________.
body part
Match the following materials with their characteristics:
Plaster of Paris = Often used for casting Neoprene = Provides support and stability Lycra = Stretches and conforms to body shape
What is the purpose of restricting unwanted motion in orthoses?
To prevent contractures
Splints can be used to mobilize the injured joint.
False
What is a crucial consideration in skin integrity management when using splints?
Preventing skin irritation and ulceration
The American Society of Hand Therapists provides guidelines for ______________________ in orthoses.
wearing schedules
What is the purpose of using orthoses during the inflammatory phase?
To support and protect the injured tissues
What is a commonly used technique to mobilize the repaired tendon during the immediate (early) passive phase?
Using the other hand or rubber bands
Nutrients are directly provided to tendons through blood vessels.
False
What is thought to assist with the delivery of nutrients to the tendon during mobilization?
Movement of the tendon within the tendon sheath
The mobilization technique that requires a high level of therapist skill uses ____________________.
the other hand or rubber bands
Match the following immobilization techniques with their characteristics:
Immobilization in a splint or cast = Used for 6-8 weeks Two-strand suture technique = Requires high level of therapist skill Mobilization using other hand or rubber bands = Not commonly used
For which type of patients is immobilization in a splint or cast for 3-4 weeks appropriate?
Non-compliant and multi-trauma patients
Zone 1 and 3 Flexor Tendon Zones have a lot of soft tissue issue.
False
What are the benefits of using immobilization in Zone 1/2 injuries?
Cheaper and easier to implement
Flexor tendon zone 2 has _______________ ligaments.
Annular
Match the following Flexor Tendon Zones with their characteristics:
Zone 1 = Not a lot of soft tissue issue Zone 2 = Annular ligaments (A1,A2,A4) Zone 3 = Early active protocols Zone 4, 5, and 6 = Early active protocols
Tendons receive nutrients directly through the tendon sheath.
False
What is the primary reason for choosing joint positions during treatment?
To reduce the possibility of tightening of joint ligaments
What is the importance of tendon nutrition in tendon repair?
Nutrients are provided to tendons directly through blood vessels to the tendons and vincula.
Study Notes
Flexor Tendon Zones
- Zone 1: FDS is working, FDP is not; nil flexion at DIP; mobilization required
- Zone 2: Annular ligaments (A1, A2, A4 pulley); laceration = worse adhesions, reduced ROM
- Zone 3 and 4, 5 and 6, 7 and 8: Early active protocols
Extensor Tendon Zones
- Odd zones on joints
- Zone 1 and 2: Mobilization, only isolate DIP
- Zone 3 and 4, 5 and 6, 7 and 8: Early active protocols
Mobilization
- 6-8 weeks
- Includes protected active mobilization of uninjured structures
- Includes protected passive ROM of repaired tendon
- No dynamic components (elastic bands, etc.)
- Use other hand or rubber bands to create glide of the repaired tendon
- Tolerated by two-strand suture technique; requires high level of therapist skill
Orthoses
- Functions: immobilization, mobilization, restriction, support a painful joint, immobilize for healing, restrict unwanted motion, prevent contractures, substitute for weak or absent muscles, restore mobility
- Precautions: impaired skin integrity, pain, swelling, stiffness, sensory disturbances, increased stress on unsplinted joints, functional limitations
- Written instructions: wearing schedule, possible complications, precautions, cleaning instructions, contact details for therapist, date for review appointment
Splinting
- Functions: immobilize, mobilize, restrict, support a painful joint, immobilize for healing, prevent contractures, substitute for weak or absent muscles, restore mobility
- Precautions: splinting material may stick to nail polish on finger nails, bond to acrylic nails, melt if left on the dashboard of the car
- Materials: low temperature thermoplastics, plaster of Paris, neoprene, leather, lycra
Tendon Nutrition
- Poor/small blood supply
- Nutrients are provided to tendons directly through blood supplied via blood vessels to the tendons and vincula
- Nutrients are also provided via diffusion into the tendon from the synovial fluid surrounding the tendon
- Movement of the tendon within the tendon sheath is thought to assist with nutrition
Flexor Tendon Zones
- Zone 1: FDS is working, FDP is not; nil flexion at DIP; mobilization required
- Zone 2: Annular ligaments (A1, A2, A4 pulley); laceration = worse adhesions, reduced ROM
- Zone 3 and 4, 5 and 6, 7 and 8: Early active protocols
Extensor Tendon Zones
- Odd zones on joints
- Zone 1 and 2: Mobilization, only isolate DIP
- Zone 3 and 4, 5 and 6, 7 and 8: Early active protocols
Mobilization
- 6-8 weeks
- Includes protected active mobilization of uninjured structures
- Includes protected passive ROM of repaired tendon
- No dynamic components (elastic bands, etc.)
- Use other hand or rubber bands to create glide of the repaired tendon
- Tolerated by two-strand suture technique; requires high level of therapist skill
Orthoses
- Functions: immobilization, mobilization, restriction, support a painful joint, immobilize for healing, restrict unwanted motion, prevent contractures, substitute for weak or absent muscles, restore mobility
- Precautions: impaired skin integrity, pain, swelling, stiffness, sensory disturbances, increased stress on unsplinted joints, functional limitations
- Written instructions: wearing schedule, possible complications, precautions, cleaning instructions, contact details for therapist, date for review appointment
Splinting
- Functions: immobilize, mobilize, restrict, support a painful joint, immobilize for healing, prevent contractures, substitute for weak or absent muscles, restore mobility
- Precautions: splinting material may stick to nail polish on finger nails, bond to acrylic nails, melt if left on the dashboard of the car
- Materials: low temperature thermoplastics, plaster of Paris, neoprene, leather, lycra
Tendon Nutrition
- Poor/small blood supply
- Nutrients are provided to tendons directly through blood supplied via blood vessels to the tendons and vincula
- Nutrients are also provided via diffusion into the tendon from the synovial fluid surrounding the tendon
- Movement of the tendon within the tendon sheath is thought to assist with nutrition
This quiz covers the process of mobilization and how nutrients are provided during the immediate passive phase, which lasts around 6-8 weeks. It also touches on the concept of tolerance and its relation to this phase.
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