Midcarpal Instability: From Testing to Treatment (Recorded Webinar)
Presented by Ann Porretto-Loehrke
What is one of the most challenging wrist conditions we see in the hand therapy clinic? Is it a patient with a crush injury involving multiple fractures and tendon lacerations, or is it the young girl involved in gymnastics who presents with progressive onset of wrist pain? Wrist instability can be a difficult condition to treat. This webinar will be covering the intricate mechanics of midcarpal instability and the two types of clinical presentations: midcarpal VISI (volar intercalated segmental instability) and the less common midcarpal DISI (dorsal intercalated segmental instability). Clinical testing for each of these conditions will be covered as well as evidence-supported treatment interventions including orthotic management, muscular engagement, and the progression with proprioceptive training. Develop tools to systematically address midcarpal instability that you can readily apply in the clinic
Learning Objectives
- Through clinical testing, distinguish between the two types of midcarpal instability: VISI and DISI
- Determine which type of orthosis will be beneficial for a midcarpal VISI versus a midcarpal DISI to promote stability with daily activities
- Formulate a treatment program for a patient with a midcarpal VISI and midcarpal DISI to promote joint stability based on evidence-supported understanding of muscle groups
- Implement proprioceptive training to optimize stability for higher-level tasks, such as gripping and weight bearing, to facilitate the patient returning to previous occupations
Meet your instructor
Ann Porretto-Loehrke
Ann Porretto-Loehrke is a skilled clinician with a passion for teaching and clinical treatment of upper extremity disorders. She has been practicing for 30 years and teaching continuing education courses for the past 20. She is the clinical development coordinator at the Hand to Shoulder Center in Appleton, Wisconsin. Ann is…
Chapters & learning objectives
1. Introduction: Understanding Midcarpal Instability From Testing to Treatment
This chapter covers midcarpal pathomechanics and clinical testing to determine which type of instability is present. Orthotic management for support, muscles to emphasize, and proprioceptive training principles will be covered to address both midcarpal VISI (most common) and midcarpal DISI conditions.
2. Case #1: Midcarpal VISI
This chapter presents a clinical case of a 15-year-old male with a midcarpal VISI. Orthotic management with a pisiform boost, exercise, and proprioceptive training will be covered.
3. Case #2: Midcarpal DISI
This chapter presents a clinical case of a 46-year-old female with a midcarpal VISI. Orthotic management to block wrist ulnar deviation, exercise, and proprioceptive training will be covered.
4. Question and Answer Session
In this chapter, we’ll review and answer the questions asked during the webinar.
More courses in this series
Rehabilitation of Nerve Transfers: Principles, Application, and Case Studies (Recorded Webinar)
Jennifer T. Dodson
Midcarpal Instability: From Testing to Treatment (Recorded Webinar)
Ann Porretto-Loehrke
Wound Care Essentials for the Hand Therapist (Recorded Webinar)
Nora Barrett
Relative Motion: Not Just an Orthosis (Recorded Webinar)
Jeanine Beasley
Rehabilitation of the Unstable Elbow: Concepts to Maximize Outcomes (Recorded Webinar)
Joey Pipicelli
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