Maitland_s_Peripheral_Manipulation_compressed

The wrist and hand complex 417 Uses Application of forces by therapist (method) • Limited or painful radial and ulnar deviation of • Starting midway between flexion and extension the wrist and hand. the therapist's thumb flexes the patient's wrist and hand to the limit of its range; the therapist's fingers • Painful restricted longitudinal movement of then return the patient's wrist to its starting the radius on the ulna at the inferior radioulnar position. joint. • The therapist's index finger is positioned near to Wrist flexion (general) (Fig. 1 3.20) the patient's metacarpophalangeal joints so as to control the return movement. • Direction: General flexion of the wrist and hand. • Symbol: F. . Uses • Patient starting position: Supine in the middle of the • As examination of wrist flexion with the addition plinth with the elbow flexed to 90° and midway of overpressure if necessary. between pronation and supination. • Therapist starting position: Standing by the patient's • As a general mobilization of wrist and hand right side beyond the flexed elbow. flexion. Localization of forces (position of therapist's • Recovery of flexion after Colles fracture. hands) • As a through-range mobilization for patients with • The right hand grasps around the medial border of osteoarthritis of the wrist. the patient's right hand. • As a neurodynamic mobilization technique in the • The thumb is placed against the dorsum of the ULNPT 2b position (radial nerve entrapment). patient's metacarpals. Radiocarpal flexion (Fig. 1 3.21 ) • The fingers are placed in the palm of the patient's hand. • Direction : Flexion localized to the radiocarpal • The left hand stabilizes the patient's forearm joint only. midway between supination and pronation immediately proximal to the carpus. Figure 13.20 Wrist flexion (general). Fig ure 13.21 Radiocarpal flexion.