A few tricks...

Alright, here I am on my final week in hands at RPH and I am happy to say that I am still absolutely loving it! ON this prac I have seen lots of different upper limb injuries, but one I wanted to discuss, is the traditional distal radius fracture. This is so common, and I can't really narrow it down to a specific age or gender... I've had everyone from a 60yr old man to a 21 yr old woman present with it. The thing that surprises me most about this injury is the amount of time it takes to recover!! Most of the pt's I have seen have made huge advances in range during the first six weeks but then progress seems to slow for a few weeks before the next period of improvement. I guess in my inexperience I expected a full recovery in 8-12 weeks, but to my surprise, on talking to my supervisor, it can take 18-24 months to regain full strength back!! WOW! Another surprise is the variability in progression that exists between pt's... Despite similar treatment, one pt may progress beautifully - within six weeks having regained full pain-free ROM, whereas another may be stuck with a stiff and painful wrist for more than eight weeks following ORIF and Early AROM ex's. This can be a little disheartening for both me and the pt, but it is comforting to know that full recovery can take many months. One technique which I have found incredibly effective is wrist mobs!! Usually after 6-8 weeks, the old PA and AP mobs in EOR extension and flexion respectively become my best friend in regaining ROM. Another technique I was shown, which we weren't taught at uni is like a SNAG but in the wrist where you stabilise the ulna and glide the radius as the pt actively supinates the wrist... a real beauty to improve supination range and therefore improve function. HAs anyone else found mobs particularly useful in treatment or picked up any little trick they'd like to share??