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The buzzing sound of the cast saw marked the beginning of the next phase in his wrist reconstruction project. With the removal of my husband's cast, all attention shifted away from the surgeon (whose job was done) to the hand therapist whose job was just beginning. Although, a question will always remain in my mind: Was that cast really necessary? Some research studies have come to the conclusion that early immobilization is not necessary following a proximal row carpectomy (PRC). But after seeing what my husband went through, I'd say that the cast certainly did help, if only to protect the surgical site while some healing took place and to prevent him from doing too much. As soon as that cast was removed, my husband noticed the vulnerability of his new hand and wrist immediately.
He experienced some initial swelling and increased pain in the first week without the protective cast. Fortunately, the topical anti-inflammatory , Pennsaid , helped keep those symptoms to a minimum. Th...
Alternative Names Pain - wrist Prevention To prevent carpal tunnel syndrome: Adjust your keyboard so that you do not have to bend your wrist upward while typing. Take frequent breaks from activities that require wrist movement. Work with an occupational therapist. To prevent gout attacks: Limit alcohol. Lose weight if you are overweight. Drink plenty of water. Eat lower amounts of liver, anchovies, sardines, and herring. Your doctor may prescribe medication. References Swigart CR. Hand and wrist pain. In: Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB, eds. Kelley's Textbook of Rheumatology . 7th ed. Philadelphia, Pa: Saunders Elsevier; 2005:chap 44. Wright PE II. Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Canale ST, Beatty JH, eds. Campbell 's Operative Orthopaedics . 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 73. Mercier LR. The forearm, wrist, and hand. In: Mercier LR, ed. Practical Orthopedics . 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 7.
In my last post, I wrote about the benefits and drawbacks of wearing splints and tried to give some suggestions for complying with a splinting regimen. I also thought that it might be helpful to talk about splinting for kids, and from a kid's perspective.
Splinting is a major treatment modality for kids. While it offers some of the same benefits as for adults, like joint protection and improved function, splints also help prevent joint deformities and contractures (shortening) of the soft tissue around the joints, like muscles and ligaments. Contractures tend to occur when the muscles around a joint are maintained in a shortened, flexed position. With RA, this sometimes happens because inflammation makes it impossible to straighten a joint completely or because it sometimes feels better to favor the limb or digit by keeping it flexed. They can also occur because of unequal growth of bones making up the joint; a common problem for children wit...
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