Physiotherapy Case Study: Fractured Finger Treatment with Online Physiotherapy
by Physiotherapist Dr Madhura Bhagat (PT) (BPT, MPT – Orthopedics)
Online Physiotherapy for Fractured Finger Treatment: ABSTRACT
Mr Mahesh (30 years, name changed) had a fractured finger while playing a sport. His hand was immobilised after it was treated using an external fixator. He used online Physiotherapy to complete his fractured finger treatment due to the lockdown situation. Despite an initial apprehension he took the video consultation. The first physiotherapy session itself left him confident of his recovery, “I am very excited to see the progress on my joint.“ The patient is extremely cooperative and regular with his home exercises. He is showing steady changes and continues to show recovery.
Online Physiotherapy for Fractured Finger Treatment: PREFACE
Mr Mahesh (30 years, name changed) was playing cricket with his friends one weekend in February 2020, when he accidentally injured his hand while bowling. The pain and swelling in the hand were unbearable and kept increasing. He visited a nearby hospital where he was diagnosed with hand fracture. He had fractured the middle bone of his ring finger. As the fracture fragment was also displaced, the doctor opted to fix the fractured finger with an external fixator. The patient’s hand was also immobilised in a cast for 6 weeks after that.
Once the cast was removed, the patient was asked to start physiotherapy for fractured finger. Patient underwent one session with a physiotherapist. It was already past mid-March by then. Due to the prevailing Covid-19 situation, lock-down was implemented and he wasn’t able to go for any further physiotherapy sessions. As this was not anticipated by his physiotherapist, he had not been given any home program either. As a result, the patient was apprehensive to perform any exercises or mobilisation by himself. He let his finger be – as it is, without even touching it, as much as possible.
Ten days after the lock-down, he came to know that ReLiva was offering tele physiotherapy services to patients. He was apprehensive about how online physiotherapy could help him, but he decided to go for a trial session.
Online Physiotherapy Appointment & Scheduling:
The patient was given an appointment for the assessment & consultation and a session length of 30 to 45 minutes was already informed by the appointment team. Our source of communication for the consultation was the video call feature on Whatsapp via the mobile phone.
Online Physiotherapy Consultation:
Fracture Patient History:
Being an engineer working from home (WFH), the patient’s main concern was to be able to type on the computer effortlessly, a task which he was managing with only one hand so far. On his own, he had started immersing his hand in hot water to mitigate the pain, but apart from that he hadn’t done anything for the affected joint.
Online Physiotherapy Assessment:
Upon detailed assessment, it was found that he barely had 20 degrees of passive range at his PIP joint. However, fortunately, his was a case without any complications or neurovascular deficits (red flags were ruled out). In fact, he had stiffness as well as swelling at the PIP and DIP joint of his ring finger. Rest of the joints of the wrist and hand were not stiff, after immobilisation. Range deficit was identified as the dominant problem area, as pain was relatively lesser – Patient rated it as 4/10, that too only on movement.
Online Physiotherapy for Fracture Treatment
The patient was advised to use contrast bath for his hand instead of only hot water immersion to counter pain and swelling, more effectively. The first session was more of an informative one, where the patient wanted to get answers to several of his doubts and questions about his case, especially pertaining to recovery and prognosis. He had many concerns about his finger, but due to the sudden turn of events he was left out of touch with his orthopaedic surgeon as well as his physiotherapist. He had no other reliable source of information to resolve his doubts. We were glad to reassure him and answer all his questions.
In the first session, we taught him basic self-assisted mobilisation for stiff joints. When the patient moved the joint by himself for the first time in many days, the shift from fear to relief on his face was tremendous! He was immediately on-board to take up further sessions and excited to see the progress on his joint.
Online Physiotherapy for Fractured Finger – Selfcare
He was then advised to repeat the contrast bath and self-mobilisation exercises on his own, in the required dosage and was given the next appointment.
Online Physiotherapy Treatment: Session 2 (Day 4)
In the next session his progress was reviewed. Thereafter the following objective baseline measurements were established:
- Range of motion
- Swelling (girth of finger)
The patient was initiated into exercises for strengthening of proximal joints. We took extra efforts to communicate that “Exercise is Medicine” and that it should be taken in the prescribed dosage and frequency religiously.
Online Physiotherapy Treatment: Maintenance
In this case, the patient is extremely cooperative and regular with his home exercises. He is showing steady changes and will hopefully continue to progress in the same manner.
We will continue to update this blog as the patient progresses with his tele physiotherapy treatment for fractured finger.
Online Physiotherapy for Fractured Finger Treatment: CONCLUSION
Overall, tele physiotherapy is a new way of treating and delivering physiotherapy care and it seems to be working well. A large number of cases could be treated in the same manner – selfcare, exercise prescription and movement training could be taught to patients online. Patient also find it very convenient, as they can:
- Schedule their appointment as per their convenience around their work hours,
- Continue their physiotherapy treatment in the safety of their home
- Use assistance of other family members, wherever required
Should you or a loved one need treatment for fracture, physical pain like back pain, sports injury, shoulder pain, knee pain or expert care for Facial palsy, Pregnancy exercises etc, register for an online physiotherapy session here or simply call us at +91 99209 91584 and we will connect you with a physiotherapist best suited for your condition.
Related Reading for Online Physiotherapy:
Shoulder Pain Treatment with Online Physiotherapy
Online Physiotherapy: Case study for Lower Back Pain Treatment
Hemiplegia Treatment: Online Physiotherapy
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