PhysioguidebydivyaA

  Handicaps The WHO has identified six handicaps: Locomotor handicap ( which forms 60%  of all handicaps)  Visual handicap Hearing and speech handicap Cardiopulmonary handicap Intellectual handicap and Emotional disturbed.  Many patients suffer from multiple handicaps, which include combinations of any of the six given above. 

  Modification in the daily activities   for Rheumatoid and other forms of arthritis Using western toilets Bath aids and railings Long handle broomstick and mop to clean the floors Use of walking sticks while walking, climbing, etc.  High chairs.  Avoid squatting on the ground for food, etc. Use of dining table and chairs are recommend.  To avoid squeezing clothes after washing and just rinsing them dry To avoid walking on hard and uneven and rough surface s.  To sleep on a hard surface. 

  Erb's Palsy  This is due to injury to the C5 nerve root and rarely the C6 nerve root is also injured.  It occurs either very early in life due to birth trauma (obstetric palsy, due to faulty application of forceps) or in young adults due to bike trauma Klumpke's Paralysis This is also due to either a  birth trauma or a bike trauma.  The C8 T1 nerve roots are involved and there will be paralysis of the wrist flexors, finger flexors and intrinsic muscles of the hand. This results in a claw hand deformity. 

Varieties of Compound Fractures Type I Wound is less than 1 cm in size. It is usually due to a low-velocity trauma. Type II Wound is more than 1 cm and less than 10 cm but there is no devitalisation of soft tissue and is associated with very little contamination. Type III Wounds moderate and severe in size (> 10 cm). And the soft tissues are devitalized and contaminated. Type IIIA Extensive soft tissue injury but with adequate soft tissue to cover the fractured bone.   Type IIIB Extensive soft tissue damage and loss. Bone cannot be covered and is exposed to the atmosphere.  Type IIIC Compound fractures with arterial injuries.  Classification (Gustillo and Anderson's Classification) 

  Flexor tendon injuries Both flexor digitorum superficialis(FDS) and flexor digitorum profundus(FDP) can be injured single or together. Flexion of the proximal IP joint of the finger is brought about mainly by FDS and since FDP crosses this joint, it also aids FDS but FDP is solely responsible for the flexion of distal IP joint flexor tendons that lie on the palm side of the hand help in bending the fingers . Extensor tendon injuries Extensor tendon of the hand are less commonly injured than the flexor tendons and are commonly seen in injuries to the dorsum of the hand, compound fractures of fingers and hand.  Extensor tendons present on top of the hand help with straightening the fingers .

Tennis Elbow It is a lesion affecting the tendinous origin of common wrist extensors from the lateral epicondyle Inflammation on the end of the outer elbow Golfer's elbow It is a tendinopathy of the insertion of the epitrochlear muscles ( flexors of the fingers of the hand and pronators).  Inflammation on the end of the inner elbow

  Genu Valgum(Knock knee)  It is an outward deviation of the longitudinal axes of both tibia and femur. Apex of the curve or angulation of the knee is medial Knees close together; ankle space increased Genu Varum(Bow legs)  It is defined as lateral angulation of the knees. The longitudinal axis of femur and tibia deviates medially Knees are curved out & ankle space decreased Genu Recurvatum Genu Recurvatum is defined as backward bending of the knee . Up to 5° of genu Recurvatum is sometimes seen in women with lax ligaments and is usually generalized. 

  Hallux Valgus Another name:- (Bunions)   It is a deviation of the great toe at the metatarso phalangeal joint away from the midline Hallux Rigidus Another name:- ( big toe arthritis, stiff big toe )  In this condition there is pain and stiffness in the MTP joint of the great toe. 

  Monteggia Fracture U  = ulna fracture R = Radial head dislocation It is a fracture of upper third of ulna with dislocation head of the radius.  Galeazzi fracture R = radius fracture U = ulna dislocation It is fracture of radius at the junction of middle and distal third with associated subluxation Or dislocation of the distal radioulnar joint. 

  Sciatic pain  Here pain radiates along the course of the sciatic nerve and is felt in the back, buttocks, posterior of the thigh, legs and the foot. Common cause is disc prolapse Other Causes Spondylolisthesis.  Sacroiliac joint arthritis.  Affliction of the nerve root by herpex simplex virus can cause radicular pain. Tuberculoma causing cord compression.  Lymphomas and pelvic malignancy.  Incurled thickened ligamentum flavum.  Cysts of the sacral nerve root.  Intraspinal neurofibromas and other tumors.  Hemorrhage in the ependymoma can cause sudden and gross neurological deficit, mimicking acute disc prolapse.  Diabetic neuropathy. Etc.., 

  P hysiotherapy during the stage of Paralysis Measures to control pain.  Measures to control edema.  Measures to prevent contractures.  Exercise regimen.  Measures to control joint stiffness.  Post paralytic stage Motor re-education Sensory re-education Split modification Electrical stimulation Electro-diagnostic tests Measures to prevent joint contractures and stiffness