Right Hand Follow Up Case Study

There are many specific types of fracture that occur in the thumb and first metacarpal, fractures of the proximal phalange and distal phalange are simpler to manage than the more complex Bennett and Rolando fractures which involve the joint between metacarpal and carpal bones (Day & Stern, 2010). If a fracture occurs in the first metacarpal, or proximal or distal phalange the patient will experience pain to the thumb, the area may appear bruised and will swell; patient also in most cases experience a loss in function and are unable to complete tasks such as pinching motions (The Royal Berkshire NHS Trust, 2013). Anne is not experiencing any loss of function in her arm and there is no swelling of the thumb; consequently, it is unlikely that Anne has fractured her first metacarpal, distal or radial

In addition Allen could not raise his arms against gravity, had flaccid lower extremities, and was without triceps or wrist extensor reflexes, and other muscle stretch reflexes were absent. If the fracture was at C4-5 Allen would not be able to shrug his shoulders and if the fracture was at C7 he could extend his flexed arms.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this

I met Mr. Eigner at the office of Dr. Taha. Mr. Eigner reports he is not taking any pain medications at this time. He reports he has a jolting shooting pain to the right and left legs only occasionally. He denied any pain to his right forearm. X-rays taken showed good alignment and healing of the fracture. The incisions are all healed except for a couple small spots on the right ankle. There is some swelling to the right ankle which Dr. Taha said is to be expected. The range of motion to the left ankle and toes was good. The range of motion to the right stores was limited. Dr. Taha said there is scar tissue at times from this type of repair and he would like physical therapy to start working on that. He is still going to be non-weight bearing for another 6 to 8 weeks on the right leg. He is now allowed full weight bearing as tolerated to the left leg. Dr. Taha ordered a rolling scooter to aid with ambulation and stop using the wheelchair. I have contacted Reverence physical therapy and faxed the new orders so the service can begin. I will process the rolled scooter with directions from the adjuster. The attendant care and replacement services will continue through to the next appointment.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal

Raney was experiencing any pain to the area and Mrs. Raney replied that the only pain is in the right shoulder. Mrs. Raney was able to supinate and pronate her right wrist 30-40 degrees. Her skin was dry. Dr. Mendelson replied that at this time Mrs. Raney no longer required to wear the wrist brace and she can use the extremity. Dr. Mendelson obtained x-rays of her right shoulder as Mrs. Rainey has limited range of motion. After reviewing this, Dr. Mendelson replied that Mrs. Rainey as tremendous arthritis in her shoulder. I inquired if it was traumatic arthritis and the result of the accident. Dr. Mendelson replied that it was not related directly to the accident necessarily but her shoulder was aggravated from the accident. Dr. Mendelson continued to state that symptomatically it will get better and at some point Mrs. Raney did have a glenoral crack. Dr. Mendelson inquired about how Mrs. Raney’s shoulder was prior to the accident and she stated that it was fine and she could raise her arm above her shoulder and head but now she can’t and has had limited movement since the accident. Dr. Mendelson assessed and evaluated her lower extremity and replied that Mrs. Raney’s left incision is now healed. Her right ankle is still healing, the wound is dry and her skin is consolidating over the area. Mrs. Raney has an avagus external rotation of her foot.

The symptoms are described as dull and sharp. Weight bearing and putting pressure aggravate the pain. Current pain level is 6/10. The exam of the left lower extremity showed that the pin sites were completely healed. Skin was intact. Pulses were palpable. He was able to range his ankle comfortably. He virtually had no motion of the subtalar joint. His pain was over the lateral part if the subtalar joint. The foot was warm. Pulses were palpable. He was intact neurovasculay. There was no calf pain. Reported CT scan demonstrated that the calcaceus fracture was healed. The patient has post-traumatic subtalar joint arthritis and calcaneal cubital joint arthritis. Plan: steroid injection, shoe wear and activity modification. If conservative treatment fails, he will benefit from a subtalar joint

Some of the injuries that can occur in the hand are Cubital Tunnel Syndrome and Carpal Tunnel Syndrome along with many more. Cubital Tunnel Syndrome causes pain or numbness in the ring and little fingers, but could also go to the arm (Types of RSI, 2010). Occurs when the ulnar nerve is pinched along the elbow’s edge (“funny bone”), and has tingling or painful feeling (Types of RSI, 2010). Cubital Tunnel Syndrome can be treated by avoiding putting pressure on the “funny bone” (Types of RSI, 2010). Cubital could lead to surgery if the nerve needs to be relieved. Carpal Tunnel Syndrome is similar to Cubital but occurs in the three first fingers. A major nerve is compressed which passes over the carpal bones through the front of the wrist (ASSH, 2015). When the nerve is compressed it causes painful, tingling and numbness in the first three fingers (ASSH, 2015). Carpal Tunnel Syndrome can be treated without surgery by changing the patterns of hand use and/or wearing wrist splints at night (ASSH, 2015). If severe then surgery can take place to make the nerve have more

Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent

DOI: 1/23/2014. This is a 36- year old male relief driver who sustained injury while he was putting away the automatic tarper when he was struck on the right shoulder and got driven into the ground and twisted his right foot. Per OMNI, he was diagnosed with right shoulder strain, and back/neck/right foot fracture. As per office notes dated 6/3/16, the patient is complaining of numbness in all extremities specifically the bilateral feet, arms and bilateral elbows. He has had a flare-up of pain that past couple of weeks around lateral column of the right foot made worse with walking and standing. He has been taking Neurontin 300 mg thrice a day which is helping control his symptoms. He apparently had a bilateral upper extremity upper extremity

who had a complication with a tendon in the finger. I witnessed the progression of

She said, she fell last night while playing volley ball. She landed on her right shoulder and heard a pop sound, too. She did not take any pain medicines. She applied icepack and felt burning pain. This was an interesting musculoskeletal assessment case. We assessed her right shoulder and compared with the left one. We found slight dislocation of the shoulder joint. She had good circulation in her right arm, no swelling noted in the right hand and the capillary refill was < 2 secs. Mary said, since she had burning pain, it could be a nerve injury, too. We also noted a slight swelling of her trapezius muscle on the right side. She complained of pain on palpation. Mary applied a sling to her right arm to keep it elevated. She may need an MRI to see the damage. Mary sent her to the urgent care. She told her that, since she heard the popped sound, the ER or Urgent care doctor can replace it. It will be a painful procedure, and she will need a strong pain medicine. She gave her the note for her teacher and asked her friend to drive her to the urgent

The clinical signs of this fracture are swelling and pain in the scaphoid region, tenderness in the “anatomical snuffbox”, pain on axial compression, pain while pronating the hand, and painful pinch grip2. Radiological diagnosis consists of a scaphoid series of X-rays: Anterior-Posterior, lateral, semipronated and semisupinated views2. In cases of so-called "occult" fractures, the fracture is not visible on the radiographs, if the clinical signs are highly suggestive of fracture a 2 week period of cast immobilization is recommended, followed by a repeat X-ray series2. If further investigation is required, CT and MRI scans can also be implemented.

Based on the progress report dated 10/07/16, the patient presents for evaluation of carpal tunnel syndrome on the right shoulder.

Mr. Jack Hoover, a 35-year-old man who are recently an athlete; he presents fracture in proximal phalanx of thumb and in malleolus also. In his past medical history showed that he had eupnea, arthralgia and muscular hypertrophy. In addition, he used to have some problems related to malleus bone due to previous trauma. Based on his recent record that we got from the department of neurology, there is no symptom of neuropathy.