Hand Therapy - General

Area/s requiring treatment: - Right wrist, sustained injury on 20 October 2024. - No surgery required. Mechanism: - Fell from a bicycle, landing on outstretched hand. Patient background: - Right hand dominant. - Works as a software engineer. - Lives with spouse and two children. Past Medical History: - No significant past medical history. - No relevant social history. - No relevant family history. - No exposure history. - Up to date with immunizations. - No other relevant subjective information. Subjective/current symptoms: - Reports pain in the right wrist, following a fall. - Pain is described as a sharp ache, located on the dorsal aspect of the wrist, rated 6/10. Pain is worse with movement and better with rest. - Patient has tried over-the-counter pain medication (ibuprofen) with minimal relief. - Symptoms have remained consistent since the injury. - No previous similar episodes. - Difficulty with typing and lifting objects, impacting work and daily activities. - No associated symptoms. Objective: - Blood pressure: 120/80 mmHg, Heart rate: 78 bpm, Respiration rate: 16 breaths/min, SpO2: 98% on room air. - Observation: Mild swelling and bruising over the dorsal wrist. Palpation: Tenderness over the scaphoid and distal radius. Range of motion: Limited wrist flexion and extension. Grip strength: Reduced compared to the left hand. Neurovascular: Intact. Investigations: - X-ray of right wrist: Revealed a non-displaced fracture of the scaphoid. Assessment: - Scaphoid fracture, right wrist. - Differential diagnosis: Distal radius fracture, wrist sprain. Treatment: - Custom wrist orthosis prescribed for immobilization. Wearing regime: Worn full-time for 6 weeks, removed for hygiene and exercise. Exercises prescribed: Gentle range of motion exercises for fingers and elbow. Precautions discussed: Avoid heavy lifting and twisting motions. - Occupational therapy planned. Plan: - Follow-up X-rays in 6 weeks to assess fracture healing. - Referral to hand surgeon if fracture does not heal. - Patient education on orthosis use and home exercise program.