The Challenge of the Stiff Hand

Clinical experience confirms certain risk factors for stiffness in the hand. The more tissue traumatized, the greater the likelihood of stiffness. Severe trauma injuring bone and multiple soft tissue layers usually requires longer periods of immobilization because of the need to regain skeletal stability. The decrease in tissue elasticity that accompanies increasing age creates less tolerance for the insult of trauma. Infection that extends the wound beyond its mechanically created boundary creates adherence between multiple remote tissue planes. Although we know these basic facts, many questions about stiffness in the hand remain unanswered... View Complete Chapter

Chapter 67: Rehabilitation of the Hand and Upper Extremity, eds: Skirven, Osterman, Fedorczyk, and Amadio, 6th ed, p894-925, Elsevier Mosby, 2011


Clinical Pearl No. 34 – Edema Control Instructions for Patients

Clinical Pearl No. 32 – Immobilizing the MP Joint in Extension?

Clinical Pearl No. 31 – Waiting for Tissue to Grow

Clinical Pearl No. 27 – Complex Made Simple: Pasta Transfer

Clinical Pearl No. 26 – Use of a Relative Motion Orthosis for Regaining PIP Joint Flexion or Extension

Clinical Pearl No. 24 – Tissue Maturity

Clinical Pearl No. 22 – Lumbrical Muscle Tightness & Testing

Clinical Pearl No. 21 – Nuances of Interosseous Muscle Tightness Testing

Clinical Pearl No. 20 – Quantifying Interosseous Muscle Tightness

Clinical Pearl No. 19 – Interosseous Muscle Tightness Testing

Clinical Pearl No. 14 – How Long Should I Serial Cast a Finger?

Clinical Pearl No. 12 – Why I Avoid Passive Flexion of the DIP Joint

Clinical Pearl No. 9 – To Glove or Not to Glove; That is the Question

Clinical Pearl No. 2 – Pre-Operative Serial Casting for Dupuytren’s Contracture Involving the PIP Joint

Book Chapter - Functional Fracture Bracing, Rehabilitation of the Hand and Upper Extremity – 2011

Journal Article - Exercise Splint for Effective Single-Finger Active Hook Exercises by Ahearn, D and Colditz, JC, Journal of Hand Therapy – 2005

Journal Article - Lumbrical Tightness: Testing and Stretching [Abstract only], Journal of Hand Surgery 2002

Journal Article - Efficient Mechanics of PIP Mobilisation Splinting, British Journal of Hand Therapy – 2000

What Do You See? No. 4 - The Lumbrical-Plus Finger

What Do You See? No. 2 - Finger Scissoring

Video Clip - Drawing the Dorsal Apparatus