Hand function recovery
Hand function is determined by the anatomical structure of the hand, and the normality of the anatomical structure of the hand is the guarantee for the strength, accuracy, and coordination of hand movements.
1, Normal function
(1) Characteristics of normal hand movement function
The normal grasping function of the hand depends on the integrity of the hand bones and joints, the balance of muscle and nerve movement, and the normal transmission of sensory nerves in the hand.
The main function of the hand is to grip, but it is quite delicate and complex. Normal hand function grasping can be summarized into 13 basic forms, including suspension, hold, touch, push and press, tap, dynamic manipulation, ball grip, ball pinch
Cylindrical Grips, Hook and Pull, Tip Punch, Multiple Tip Pinch, and Lateral Pinch
According to the functional mode of the hand, it can be simply divided into two categories: power grip and precision grip.
1. Force grip is an action caused by the movement of the thumb and the flexion of the ring finger and little finger against force, resulting from the mutual movement of the thumb and the ulnar fingers (ring finger and little finger).
2. Precise grasping is the action of the thumb, index finger, and middle finger bending against force, resulting from the mutual movement of the thumb and radial fingers (index finger and middle finger). The movement of the thumb tip towards other finger tips is called thumb opposition, which is a necessary condition for ensuring normal hand function.
(2) Characteristics of normal hand sensation function
The normal sensory function of the hand allows people to operate objects and experience the quality of various objects with their hands, protecting themselves from injury and stimulation. Once a person's hand loses normal nerve innervation, it is like losing a hand, and efforts must be made to help nerve damaged patients recover their function as much as possible.
1, Hand injury
With the continuous improvement of people's ability to engage in daily activities and the expansion of their range of activities, the incidence of hand injuries is also increasing. After hand injury, some patients can directly recover through occupational therapy, while others must undergo hand surgery before entering the occupational therapy process. Occupational therapists need to work closely with rehabilitation physicians and hand surgeons to jointly develop rehabilitation treatment plans.
(1) Cause of injury
There are many reasons for hand injuries, which can be roughly divided into:
1. Hand injuries such as burns, cuts, falls, squeezes, crushing, tears, gunshot wounds, twisting, explosions, bites, etc.
2. Hand injuries after diseases, such as rheumatoid arthritis, traumatic arthritis, degenerative arthritis, peripheral neuropathy, central nerve injury and hand dysfunction after brain injury, diabetes peripheral nerve injury, traumatic brachial plexus injury, primary myopathy and muscle atrophy, etc.
3. Congenital developmental disorders such as congenital hand or upper limb skeletal dysplasia, neurodevelopmental dysplasia leading to hand dysfunction, etc.
Peripheral nerve injury in the hand can be caused by direct trauma (such as stabbing, cutting, burning, etc.) and indirect trauma (such as fractures, vascular diseases, etc.).
Most patients with upper limb dysfunction require hand function rehabilitation, including upper limb trauma and/or surgery, upper limb dysfunction after central nervous system injury, amputation surgery, and so on. Meanwhile, patients with rheumatoid arthritis, traumatic arthritis, and degenerative arthritis often require hand function rehabilitation. Some special diseases also need hand function rehabilitation, such as congenital upper limb skeletal dysplasia, peripheral neuropathy, diabetes peripheral nerve injury, traumatic brachial plexus injury, primary myopathy and muscle atrophy.
According to the time after injury, it can be divided into acute injury and chronic injury.
(2) Injury site
1. Skin
(1) Hand skin cutting injury: Cutting injury is a common type of hand trauma, and the simplest cutting injury depth generally does not exceed subcutaneous tissue. If the cutting site is deep, it may damage tendons, nerves, blood vessels, and even bones.
(2) Hand skin tear injury: Skin tear injury is one of the more serious types of hand trauma. In clinical practice, this type of injury is commonly caused by hands being caught in rotating machinery and equipment during work. In severe cases, the entire skin of the hand may be completely torn off, including some subcutaneous tissue, which is called hand skin delamination injury. Severe skin avulsion injury is not only skin damage, but may also include all soft tissue injuries under the skin, such as blood vessels, nerves, tendons, etc.
