Last month, my mom fell and got her hand injured and she suffered bone fracture on the wrist area as a result of that. The doctor at that point of time treated the condition by having her to put on the hand support bandage in which the fingers are wrapped in static positions without any space to move. She was on bandage for one month, and as the bandage got removed, the hand became very much swollen, stiff and weak. She couldn't grip or hold anything at all. The hand could not close totally to a fist. And since it's on the right hand and being a right handed person, that makes her having difficulity carrying out daily routines. Doctor said it's normal and advised her to take vitamin C and calcium supplement, and avoid to give any pressure to the hand.
Now that it has already been 2 weeks it seems like the condition has not gotten any better. Now the concerns are whether it's normal for the hand to be still stiff, swollen and unable to grip or hold or make a full fist after 2 weeks since the bandage got removed. And also, are there any other methods to exercise the hand without cauing extra pressure on it in order to bring back hand to normal strength? Your advice is highly appreciated.
The hand and fingers will get very stiff, very quickly, when not moved. It is unfortunate that the splint was put on all the way out to the tips of the fingers, so that the fingers could not be moved at all. Because, usually, unless the fingers themselves are injured, the splint is stopped at the base of the fingers, so that they can be exercised.
But, that is a moot point now. You have to deal with what you have. Doing absolutely nothing is not really the best thing to do. Of course, you should not go out and really abuse the hand, but, it must be moved to get the motion back. The longer range of motion is not done, the stiffer the fingers will become, and the harder it will be to regain the motion.
The best thing is active motion, where the patient actively moves the finger and wrist as much as she can. It is better to warm up the tissues first. This can be done with hot packs, hot shower, hot bath, whatever. Warm tissues are more pliable and will stretch better.
If the underlying bone injury is such that it cannot withstand just moving the fingers, then it is not ready to be out of immobilization. And again, the hand is not going to get any better, just sitting around not doing anything. The fingers have to be moved to get better. They are not going to get better just being held still.
If she is really stiff, she may need to see an occupational therapist (hand therapist). The therapist can do some friction massage on the scar tissue in the fingers and help her to get the fingers moving with block and hold techniques.
The use of TheraPutty is great. It is a putty like stuff that you can get from hand therapists. You can squeeze it all the way down into the palm and it comes in different stiffnesses. Using a ball is not recommended, because the fingers do not move. It is basically an isometric exercise. The putty allows the fingers to move all the way down into the palm, through a full range of motion.
If, however, she does not begin to get the motion back in the finger shortly with exercise, she needs to be evaluated by a hand surgeon or orthopedic surgeon. Stiffness is a very difficult problem to overcome. Especially in the older population. She would also need to be evaluated for a condition called complex regional pain syndrome I (CRPS I) which used to be called RSD (reflex sympathetic dystrophy). In this condition, which can occur after a minor injury, the fingers become very stiff, tender, red, swollen, and are described as having pain out of proportion with the underlying injury. Not to say that she has this, but, if she is not getting the motion back, it is something that needs to be evaluated for.
So, she really needs to start moving the fingers, on the hour, every hour. She can also massage the fingers herself, starting at the tips and moving towards the hand. Trying to break up scar tissue and move the edema out. She can use the other hand to help gently bend the fingers down and hold for a count of 10. Straighten them, then bend again for a count of 10. Just keep repeating this several times a day. Also, warm up the tissues.