Fractures/Breaks

The words fracture and break are interchangeable when talking about bones. Simple fractures that are in alignment can be treated by immobilising the finger, hand or wrist. At HULC we are specialists in making custom-made, lightweight thermoplastic splints, also known as an orthosis, to support the fracture whilst it heals. These splints are made to measure at your first appointment and can be modified if your hand/ wrist changes shape due to factors, such as a reduction in swelling. Another bonus is these splints can get wet!

For complex breaks that require surgery to fix and align the bones, a splint can be made post-operatively.

Hand therapy is vital in the case of any hand or wrist fracture to optimise movement and function post injury.

Wrist pain

The wrist is a very complex joint. We are specialists in assessing and treating various causes of wrist pain. Pain can be caused by a number of things, including inflammation, ligament strains/ tears, over use injuries, arthritis, hypermobility, old fractures, nerve compressions and weakness.

Our therapists are widely experienced in treating the many causes of wrist pain and use a number of different treatment tools and techniques to help relieve your pain and maximize mobility.

Finger dislocation

Finger dislocations are one of the most common injuries we treat, particularly in sports people.  The most common joint to injure is the Proximal Interphalangeal joint (the middle joint of your finger).

Joints are surrounded by soft tissue to allow them to move with stability. When a joint is dislocated some of these structures are invariably damaged. A custom-made splint is recommended to protect the soft tissues as they heal, whilst hand therapy will prevent the joint from stiffening.

Nerve compression/ numbness in the hands

Carpal tunnel syndrome is the most common nerve compression that affects the hand and wrist. Symptoms usually include pins and needles, numbness and pain in the thumb, index and middle finger.

Nerves can also be compressed at other areas in the upper limb including the elbow, shoulder and neck.

We commonly treat nerve conditions and beneficial treatment can include splinting to rest the nerve, home exercise programs and activities to desensitise the nerve.

Dupuytren’s Fibrosis Condition

Dupuytren’s Fibrosis is a genetic condition where your fingers are pulled into your palm by thickening of the tissue under the skin. It is more common in men, people of northern European descent and onset is generally delayed until the 4th and 5th decade of life.

A referral to a surgeon is required for treatment. Consequently, HULC has set up a pioneering ‘Dupuytren’s Clinic’, the first specialist clinic of its kind, together with eminent hand surgeon Mr Jeff Ecker.

Our specially trained Dupuytren’s Fibrosis hand therapists run this specialist clinic to measure the hands every 6–12 months to detect progression or extension of the condition and intervene before there are major contractures. This way, people can have simple minimal intervention to control the disorder and delay or avoid major complex surgery.

Our specially trained therapists work closely with your surgeon to oversee and monitor your condition. We assist in post-operative management of this condition, including wound care, splinting, scar management and regaining movement.

HULC is active in researching the best surgical and post-operative treatment for this condition.

Arthritis

Arthritis is a common condition affecting many joints of the body. It can be caused by damage to the joints through wear and tear as we age, previous injuries and various autoimmune diseases.

A common joint for arthritis to affect is the base of the thumb. Hand therapy can be very effective in managing pain associated with arthritis. Treatment usually includes a mix of splinting to support the joint and relieve pain, exercise programs and advice on modification of daily activities.

Trigger Finger

Trigger finger can occur when one or more of the tendons that bend your finger has thickened or enlarged.  It then has trouble moving through a pulley. This can result in locking of the finger in a bent position and pain when trying to straighten the finger. Splinting can be an effective treatment for this condition as it allows the inflammation to settle and the tendon to reduce in size.

Mallet Finger

Mallet finger is a very common condition we see in our clinics. It is usually caused by a ball hitting the end of the finger, damaging the tendon that straightens the end joint of the finger. The finger will usually look bent, and sometimes is painful and swollen.

Immediate splinting is the best treatment to correct the deformity and assist in healing. An X-ray is required to see if this is associated with a fracture of the finger.

Lymphoedema

Lymphoedema is abnormal swelling that generally occurs in one of the arms or legs. Sometimes both arms or both legs swell. Lymphoedema is most commonly caused by the removal of, or damage to, lymph nodes as a result of cancer treatment. This causes a blockage in the lymphatic system, which is part of your immune system, and prevents the lymph fluid from draining well, and the fluid buildup leads to swelling.

Lymphoedema can be managed with early diagnosis and diligent care of your affected limb, including self management techniques and the the fitting of compression garments.

All HULC therapists are trained in the prescription of custom made Jobst and Alvarex compression garments for the upper limb. Occupational Therapist Emma Simpson also provides a management service for patients with simple upper limb Lymphoedema in our Bunbury and Busselton clinics.  Ellen Gulin provides this service in our metro clinics. Patients in the community who need ongoing management for their lympoedema can be seen at HULC, who will then liaise with their specialist service for formal reviews.