Date of Award

2009

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Schawnn Decker

Keywords

ORlF; DISI deformity; physical therapy; lunate fracture; impingement

Abstract

Background and Purpose: This case report follows a 20 year old male through his five week out patient rehabilitation for an open reduction internal fixation (ORIF) pinning of his right lunate and subsequent hardware removal following a motor vehicle accident. The patient presented with pain, decreased strength and range of motion of his right wrist. A deficit was also identified in his right shoulder stemming from decreased use of his right upper extremity. The reason for this case study is to look into benefits of physical therapy interventions as well as their functional outcomes.

Interventions: Patient warmed up on an upper arm bike and used heat prior to all therapy sessions in order to increase tissue extensibility. Stretching was applied based on patient's tolerance. Patient used resistive tubing and free weights to increase strength. Ice and electrical stimulation were applied at the end of each session to decrease any inflammation that may have been caused through the session. Treatments were kept within a pain free motion and adjusted based on patient's tolerance.

Outcomes: Following physical therapy interventions, the patient was able to return to: full right upper extremity range of motion, equal strength bilaterally, decreased pain with activity, and resume all leisure activities.

Discussion: Although it is apparent that this patient's impairments improved during physical therapy management, it is difficult to say which intervention, if any, provided these improvements or if this progress could have been due to natural healing.

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