What’s TFCC
Triangular fibrocartilage complex
Function of TFCC
- Shock Absorption
- Stabilized DRUJ
- Weight bearing
Structures involved in De Quervains
ABD Pollicis Longus
Extensor pollicis brevis
What’s in a terrible triad
- posterior dislocation ulnar on humerus
- radial head #
- ulnar coronoid process #
Structures in TFCC
-ulnotriquetral ligament
- ulnar collateral ligament
Why is early tendon gliding really important
Early mobilisation is really important after a tendon repair because tendons naturally want to stick to the surrounding tissue as they heal.
By gently moving the tendon early, we keep it sliding properly and prevent adhesions, which can limit how much you can bend or straighten your fingers.
Pathology of LE
Overload of the ECRB -> causing tendon degeneration and sensitisation
A + E LE
Avoid gripping with extended elbow; modify tools; gradual loading; takes weeks to improve.
Manual therapy LE
Mulligan MWM
Radio humeral joint mobilizations
Soft tissue massage
PFGS
exercise for LE
Isometric wrist extension → eccentrics → functional gripping.
Sensory changes for LE
reduced pain pressure threshold locally
reduced pain pressure threshold on the non affected limb
Tendon changes LE
ECRB is the most effected tendon
- Increase in cell number and ground substance
- increase in cell vascularity
Motor changes in LE
- changes to grip
- changes to wrist and finger strength
- impaired joint reaction time with wrist and finger movements
What is De Quervains tenosynovitis
Inflammation/thickening of APL and EPB tendons at 1st dorsal compartment
A + E De Quervains
Avoid thumb abduction/ulnar deviation
Exercises De quervains
ABD of thumb
What is Carpal tunnel
Median nerve compression at carpal tunnel
What movement does Medial glide of olecranon help
Elbow extension
What movement does lateral glide of olecranon help
elbow flexion
What movement does lateral glide of ulna
elbow flexion
what movement does AP or radius on ulna help
pronation
what movement does PA of radius on ulnar help
supination
what movement does AP of radius on humerus help
Supination
