Upper Extremity Conditions & Splints | NBCOT Exam Prep | OT Dude Academy

Introduction

This tutorial provides a comprehensive overview of upper extremity conditions and splinting techniques relevant for occupational therapy practitioners, particularly for NBCOT exam preparation. By understanding the various fractures, tendon injuries, nerve compressions, and their respective treatment approaches, you can enhance your clinical skills and knowledge.

Step 1: Understand Common Fractures

Familiarize yourself with the types of upper extremity fractures commonly encountered in therapy:

• Humerus Fractures: Often result from falls; treatment involves immobilization and rehabilitation.
• Elbow Fractures: Classification is important for defining treatment; typically requires splinting and therapy.
• Forearm and Radius Fractures: Pay attention to the relationship between forearm bones; may require surgical intervention.
• Metacarpal Fractures: Common in hand injuries; assess for potential grip strength loss.
• Wrist and Carpal Fractures: Important to evaluate nerve involvement for effective treatment.

Step 2: Review Treatment Approaches for Fractures

Implement effective occupational therapy treatment strategies:

• Immobilization: Use splints or casts to maintain proper alignment during healing.
• Therapeutic Exercises: Gradually introduce range of motion and strength exercises post-immobilization.
• Pain Management: Utilize modalities like ice or heat to reduce discomfort during therapy sessions.

Step 3: Outcome Measures

Utilize standardized outcome measures to assess patient progress:

• Functional Independence Measure (FIM): Evaluates a patient's ability to perform daily activities.
• QuickDASH: A specific measure for upper extremity disorders that helps track functional status.

Step 4: Explore Complex Regional Pain Syndrome (CRPS)

Recognize the signs and treatment strategies for CRPS:

• Common in individuals post-fracture.
• Treatment includes desensitization techniques and graded motor imagery.

Step 5: Understand Tendon Injuries and Protocols

Review flexor and extensor tendon injuries and corresponding protocols:

• Duran Protocol: Involves early passive motion.
• Kleinert Protocol: Focuses on controlled active motion to promote healing.

Step 6: Identify Nerve Injuries and Compression Syndromes

Learn to identify and treat common nerve injuries and syndromes:

• Median Nerve Laceration: Often leads to loss of thumb opposition; splinting is crucial.
• Ulnar Nerve Laceration: May affect hand grip; assess for claw hand deformity.
• Radial Nerve Laceration: Results in wrist drop; splinting and rehabilitation are important.

Step 7: Recognize Common Conditions

Be aware of prevalent upper extremity conditions:

• Rotator Cuff Injuries: Includes tendonitis and tears; focus on strengthening and mobility.
• Epicondylitis: Medial and lateral variations require specific stretching and strengthening routines.
• Carpal Tunnel Syndrome: Recognize symptoms and provide appropriate wrist splinting.

Conclusion

Understanding upper extremity conditions and their treatment protocols is vital for effective occupational therapy practice. By familiarizing yourself with fractures, tendon injuries, nerve issues, and treatment strategies, you can enhance patient outcomes and prepare for the NBCOT exam. Consider exploring further resources and engaging in practical applications to reinforce these concepts.