Preliminary study of elastic-tension digital neoprene orthoses for proximal interphalangeal joint flexion contracture

Flexion contracture of the proximal interphalangeal joint (PIPJ) is one of the most frequent complications in finger trauma. Orthoses are the most widely used method to optimize total end-range time (TERT). No previous studies showed that an elastic tension orthosis could be applied for longer than 12 h. We aimed to demonstrate that the elastic-tension digital neoprene orthosis (ETDNO) can achieve higher TERT and therefore better range of motion than other elastic-tension orthoses (ETO) described in the literature. A prospective study of treatment of PIPJ flexion contracture included 10 PIP joints in 8 patients who met the selection criteria. They were instructed to use the ETDNO for around 23 h per day as far as possible, during a period of 3 weeks. Patients reported a mean TERT of 20.6 h a day. PIPJ contracture improved by a mean Torque Range of Motion (TROM) of 23.5° at 500 g and 22.9° at 800 g of passive extension force during the 3-week treatment. Based on the results of this study, the ETDNO appears to offer a highly effective approach for improving PIPJ flexion contracture, increasing range of motion in extension. ETDNO's efficacy probably lies in the significantly improved comfort and low-profile design, enabling excellent compliance and thus optimizing TERT. LEVEL OF EVIDENCE: Level III.

The schultz structured interview for assessing upper extremity pain

Trauma and disease processes in the upper extremity frequently cause pain as well as impairment in movement, strength and in function. While perception of pain occurs normally in response to bodily insult, prolonged or severe pain may interfere with attempts to maximize physical function and the return the involved person to optimal occupational role. Whether participating as a member on a medical or vocational rehabilitation team, the occupational therapist must adequately assess the area, nature and behavior of pain prior to providing appropriate intervention and recommendations to other team members. A structured interview to assess pain furnishes the therapist with a format for evaluation that is thorough and methodical. The structure and process of the interview allows the therapist to collect subjective information which can be coupled with objective findings from standard upper extremity evaluation and/or observation of task performance. Data gathered will assist the therapist in discovering the etiology of pain, in evaluating the appropriateness of complaints as they relate to pathology and in making appropriate recommendations about the patient's future work roles.