This year the Philly Hand Show was once again packed with educational sessions, a variety of vendors with many helpful products and most importantly, great hand therapy wisdom allowing all attendees to leave with some valuable clinical techniques. The following are just a few of the take home messages gained from the meeting.The Ulnar Wrist
Dr. Sanjeev Kakar did an informative presentation in which he seemed to be able to simplify the ever complicated ulnar side wrist pain. He broke down this pain as being from a bone deformity (i.e. involving the sigmoid notch), cartilage damage, soft tissue injury (the triangular fibrocartilage complex), muscle/tendon issue or any combination of the aforementioned.
Distal Radius Fractures
Nancy Naughton OTD, OTR/L, CHT pulled together all of the evidence on therapy for treatment of distal radius fractures and reminded hand therapists to be sure to evaluate our clients thoroughly for limitations including proprioceptive concerns, which may not be in our normal evaluation routine.As with Dr. Kakar, Ms. Naughton presented a cohesive method of viewing these clinical challenges
Flexor Tendon Repair
Judy Colditz OTR/L, CHT, FAOTA and Karen Pettengill MS, OTR/L, CHT discussed decreasing the amount of flexion at the metacarpal phalangeal joints in our dorsal blocking orthosis (to less than 60 degrees of flexion) for our post op flexor tendon repairs to assist with decreasing force on the flexor tendons and decreasing intrinsic tightness in the digits. Just on example of proof that therapy techniques continue to evolve as we expand our knowledge base.
Understanding and Treating the Thumb
Jeannine Beasley EdD, OTR, CHT, FAOTA reminded the audience that although the evidence suggests that an orthosis does decrease pain and increase function for individuals with arthritis at the base of the thumb, the best orthosis is likely client specific for each individual with this diagnosis.This was a very important reminder of the skills of the therapist to approach each patient as an individual and that rarely is a “one-size or one-splint fits all” solution.
This was a nice follow up to Judy Colditz’s OTR/L, CHT, FAOTA presentation on the thumb earlier in the conference where she suggested using an orthosis on the joint that was most deformed when a paper was torn (i.e. using an orthosis to prevent hyperextension of the thumb interphalangeal joint even when the pain is at the base of the thumb).
Virginia O’Brien OT, CHT then presented her program for dynamic stability of the thumb, which has been supported by research study to decrease pain and improve function in an average of 2.37 skilled therapy sessions.This is a technique many of us could put into effect immediately much to the benefit of our patients.
The exhibit hall was busy with a lot of learning going on there as well. The combination of hand surgery and hand therapy companies offered everyone a broad range of products to examine, try on and in some cases, bring samples back to the clinic.
3 Point Products, celebrating its 20th anniversary serving the hand therapy community, debuted the Wrist P.O.P. (Point of Pressure) for ulnar wrist pain and the Elbow P.O.P. (Point of Pressure) for lateral or medial elbow pain and the Basko CMCcare Thumb Brace from the Netherlands. These new orthoses will join Oval-8 Finger Splints, Buddy Loops and ThumSlings to bring 3-Point Products offerings to over 40 products designed for hand therapists use. Stay tuned for more information on these exciting new products due out in June.
This blog is not intended to be a full summary of the course and certainly, doesn't highlight all of the talent and information presented, but instead gives a small glimpse for those who were not able to attend. Hope to see everyone at the 2018 Philadelphia Hand Conference!