Clinical Orthopaedic Rehabilitation Volume 1 and 2

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1 Clinical Orthopaedic Rehabilitation Volume 1 and 2 COURSE DESCRIPTION This program is a practical, clinical guide that provides guidance on the evaluation, differential diagnosis, treatment, and rehabilitation of patients with orthopaedic problems. Volume 1 focuses on Hand and Wrist Injuries. Volume 2 focuses on Elbow Injuries. In an easy to use format, it covers all orthopaedic conditions and procedures from initial examination through the postoperative or post-injury period, including arthroplasty, fractures, and sports injuries. Each chapter is written jointly by an orthopaedic surgeon and a physical therapist. LEARNING OBJECTIVES Volume 1 Hand and Wrist Injuries Module 1 Flexor Tendon Injuries Identify important points for rehabilitation protocol following flexor tendon repair Identify tensile strength of the tendons Describe the strength of the tendon following repair in the acute and subacute phases of healing Describe factors that influence the formation of adhesions near repaired flexor tendons Discuss the timing of flexor tendon repairs and the influence this has on functional outcome Discuss the requirements for secondary repair of flexor tendons Understand the anatomy of the flexor tendons and how an injury in specific zones affect functional outcome following surgical intervention Describe both intrinsic and extrinsic tendon healing Describe the factors that affect tendon healing Be able to describe, in detail, the treatment options for surgical repair of lacerated tendons including teno-fix repair Develop a rehabilitation protocol following surgical intervention of lacerated tendons Trigger Finger (Stenosing Flexor Tenosynovitis) Underlying physiology of trigger finger Clinical findings of trigger finger Describe various treatment modalities for trigger finger Age group affected by pediatric trigger thumb and need for surgical intervention Page 1 of 6 Accelerated Online Learning Clinical Orthopaedic Rehabilitation

2 Flexor Digitorum Profundus Avulsion ( Jersey Finger ) Etiology of jersey finger Describe the three separate classifications of jersey finger with respect to the specific anatomy Discuss treatment options for each classification and the functional outcome following the various surgical interventions Extensor Tendon Injuries Describe the eight anatomic zones of extensor tendon injury Discuss the unique concerns of extensor tendon injuries in children Detail the functional outcome of extensor tendon injuries in zones 4 8 Give the indications for extensor tenolysis List the signs, symptoms, and classifications of mallet finger Discuss treatment options for mallet finger with respect to age, restrictions to range of motion, and splinting options Hand and Wrist Injuries Module 2 Fractures and Dislocations of the Hand List the fractures that require surgical intervention Describe the principles of metacarpal and phalangeal fractures Understand the principles of REDUCE when splinting Be aware of poor outcomes following metacarpal fractures, and how to prevent/treat such outcomes Fifth Metacarpal Neck Fracture (Boxer s Fracture) Clinical findings of boxer s fracture Treatment options and criteria Mobilization criteria and reasons for early inclusion into rehabilitation program Be aware of poor outcomes following phalangeal fractures, and how to prevent/treat such outcomes Describe the differences between stable and unstable PIP joint injuries Discuss the various types of PIP joint injuries including relevant anatomical structures affected, clinical findings and treatment options Page 2 of 6 Accelerated Online Learning Clinical Orthopaedic Rehabilitation

3 Hand and Wrist Injuries Module 3 Injuries to the Ulnar Collateral Ligament of the Thumb Metacarpophalangeal Joint (Gamekeeper s Thumb) Describe the anatomy of the MCP joint of the thumb and the mechanisms of injury for this joint Detail the clinical findings of gamekeeper s thumb Detail the treatment protocol for gamekeeper s thumb Nerve Compression Syndromes Describe the etiology and clinical findings of carpal tunnel syndrome (CTS), including degree of CTS and the special tests used to diagnosis the condition List the differential diagnoses of CTS, including causes for each condition Prepare a non-operative rehabilitation protocol for CTS Describe the goals of operative CTS treatment, and the possible complications following surgical intervention Describe etiology, clinical findings, and treatment options for bowler s thumb Hand and Wrist Injuries Module 4 Wrist Disorders Describe the anatomy of the scaphoid and how this can affect fracture healing Detail the clinical findings, including radiographic evidence for scaphoid fracture Discuss the treatment options, including splinting, for both displaced and non-displaced Fracture of the Distal Radius Describe the goals of the treatment of a distal radius fracture Be aware of how swelling can affect functional outcome Discuss the etiology and clinical findings following a fracture to the distal radius Discuss how displacement and angulation of wrist structures affects outcome List, and describe, the classifications of distal radius fractures Identify treatment protocols based on the classification of fracture Describe the indications for surgical intervention following fracture Page 3 of 6 Accelerated Online Learning Clinical Orthopaedic Rehabilitation

4 Hand and Wrist Injuries Module 5 Triangular Fibrocartilage Complex Injury Discuss how the anatomy affects outcome following injury Discuss the classifications of triangular fibrocartilage complex (TFCC) injury and the clinical findings for each Discuss diagnostic criteria for the injury and the special tests used to detect damage to the TFCC Discuss the accuracy of imaging techniques in the diagnosis of TFCC injuries Discuss the surgical intervention techniques for TFCC repair and the anatomy affected for each De Quervain Tenosynovitis Describe the clinical findings for De Quervain tenosynovitis including radiographic evidence Discuss the various treatment options including functional outcomes for each and any relevant concerns Intersection Syndrome of the Wrist Discuss the mechanism of injury, underlying pathophysiology and relevant clinical findings Discuss relevant clinical findings for intersection syndrome, de Quervain s tenosynovitis, sixth dorsal compartment tenosynovitis, flexor carpi radialis tunnel syndrome, and trigger finger including differential diagnoses Describe the conservative treatment model for intersection syndrome of the wrist Dorsal and Volar Carpal Ganglion Cysts Describe the etiology Discuss the clinical findings and treatment options Rehabilitation Develop rehabilitation protocols for all conditions listed above with the following in mind: stage of injury; type of surgical intervention Page 4 of 6 Accelerated Online Learning Clinical Orthopaedic Rehabilitation

5 Volume 2 Elbow Injuries Module 1 Pediatric Elbow Injuries in the Throwing Athlete: Emphasis on Prevention Describe the various injuries occurring at the elbow in the pediatric age group Describe prevention strategies for elbow injuries in the pediatric age group with respect to pitch type and count (baseball) Medial Collateral Ligament and Ulnar Nerve Injury at the Elbow Understand the anatomy and biomechanics of the MCL Describe the MOI and clinical findings Discuss the surgical intervention for the MCL including technique, rehabilitation techniques and protocol Discuss non-operative care and rehabilitation following MCL injury including the goals of treatment Treating Flexion Contracture (Loss of Extension) in Throwing Athletes Describe the etiology, prevalence in throwing athletes, treatment options, and returnto-play criteria Elbow Injuries Module 2 Post-Traumatic Elbow Stiffness Describe the various classifications of post-traumatic elbow stiffness including extrinsic and intrinsic causes Describe the classifications of heterotopic ossification of the upper extremity Discuss the etiology and clinical findings including radiographic evidence Detail the rehabilitation protocol for both surgical and non-surgical treatment Treatment and Rehabilitation of Elbow Dislocations Discuss the considerations when developing a rehabilitation program Describe the anatomy and biomechanics of the elbow, MOI, clinical findings and radiographic evidence Describe the classifications of elbow dislocations including both posterior and complex Detail the outcome risks of each classification Page 5 of 6 Accelerated Online Learning Clinical Orthopaedic Rehabilitation

6 Understand the operative techniques used to reduce an elbow dislocation including the complications that can occur following the injury and surgical intervention Rehabilitation concerns for simple and complex dislocations of the elbow Know what to expect following injury and surgical reduction of elbow dislocation Elbow Injuries Module 3 Lateral and Medial Humeral Epicondylitis Discuss the epidemiology and etiology of lateral and medial epicondylitis Know the relevant clinical findings and anatomic adaptations seen in athletes and how these present to the clinician Detail the special tests used to diagnosis lateral and medial humeral epicondylitis Discuss the differences in treatment protocols for tendinitis versus tendinosis Understand eccentric training programs and their place in the rehabilitation schedule Understand the design of exercise programs and when they should be incorporated into a rehabilitation schedule Design and functional rehabilitation exercise program for a throwing athlete from postinjury to return-to-play Elbow Arthroplasty Indications for surgical intervention Describe the contraindications for surgical intervention Page 6 of 6 Accelerated Online Learning Clinical Orthopaedic Rehabilitation

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