PHILADELPHIA — Jenny Dorich, OTR/L, MBA, CHT, from the Cincinnati Children’s Hospital Medical Center, discussed how to therapeutically manage children after a wrist fracture at The Hand Rehabilitation Foundation Annual Hand Surgery Symposium, here.
According to Dorich, indications that a child should receive therapy after a wrist fracture include hypersensitivity, nerve injury, a history of recent injury to the same extremity and limitations after the cast is removed. Children who are actively involved in athletics or music are often candidates for physical rehabilitation.
“The protocol or guideline that we tend to use in our clinic is that the child is seen by us around 2 weeks after cast removal,” Dorich said.
She typically focuses on regaining active and passive range of motion before focusing on strengthening, and she says that most gains are typically achieved within the first 6 months of therapy.
“In children, they have the advantage of healing so well, so they really don’t need us to do a whole lot to them,” Dorich said.
Dorich also noted that therapists and clinicians should be watching for any sign that the injury is not healing properly or worsening.
“As the therapist, we are the ones who are interacting with the children much more frequently than the physician, and I feel we have a responsibility to continue to monitor their symptoms,” Dorich said. “If there is starting to be some pain, it is appropriate to call that referring professional and express it.”
For more information:
Dorich J. Therapeutic Management of Pediatric Wrist Fractures. Presented at: The Hand Rehabilitation Foundation Annual Hand Surgery Symposium. April 6-8, 2013. Philadelphia.