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Understanding Multi-Trauma Hand and Upper Extremity Injuries (Day 1)

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1.  The correct orthosis position for a patient with a digital replantation includes:
  1. Wrist at neutral position
  2. Fingers left free for active motion
  3. Wrist in 30 degrees of extension
  4. MP joints in 70 degrees of flexion and IP joints in full extension
2.  In a patient with a digital replantation, a therapist may generally begin:
  1. Early active motion flexor tendon protocol
  2. Early passive motion protocol
  3. No range of motion
  4. Full active range of motion with no precautions
3.  The combination of edema and compression wrap in a flexor tendon repair:
  1. Allows therapists to begin early active motion protocols
  2. Decreases the work of flexion on the repaired tendon
  3. Prohibits use of early passive motion protocols until edema is resolved
  4. Increases the work of flexion on the repaired tendon
4.  Your patient has been involved in a roll-over motor vehicle accident, sustaining a crush and de-gloving injury to her left hand. She has a skin graft on the dorsum of her hand. You should:
  1. Fabricate a dorsal orthosis
  2. Begin active range of motion at one day post-op
  3. Delay range of motion of wrist and MP joints for 5 to 7 days
  4. Change dressings daily, starting at day 2 post-op
5.  EPM II protocol for digital replantation includes the following:
  1. Composite passive digit flexion
  2. Isolated passive MP joint flexion with IP joint extension
  3. Composite passive digit extension
  4. Active digit flexion
6.  Developing an algorithm for treatment of multi-trauma is superior to use of a standard protocol because:
  1. It is easier for the therapist
  2. When multiple structures are involved, there may be contradictory protocols
  3. Multi-trauma patient's injuries are always the same
  4. It doesn't require communication with the surgeon
7.  Your patient has sustained a crush injury to his right dominant hand, with an open fracture and tendon laceration. You should be concerned about which possible sequelae:
  1. Tendon adhesions
  2. Wound infection
  3. Joint stiffness
  4. All of the above
8.  The first priority in a treatment plan for a multi-trauma post-surgical patient is:
  1. Protect repaired structures
  2. Begin early active motion
  3. Mobilize fractures
  4. Delay treatment for nerve injuries
9.  Which of the following is NOT a possible contraindication for early active motion in flexor tendon repairs:
  1. Joint stiffness
  2. Prolonged steroid use
  3. Mild edema
  4. Smoking
10.  Correcting maladaptive motor patterns can be achieved by:
  1. Use of blocking orthosis
  2. Use of Graded Motor Imagery and Mirror Visual Feedback techniques
  3. Bilateral activities
  4. All of the above

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