Orthopedic Mentorship Series: Wrist and Fingers

Presented by Jared Vagy

Video Runtime: 69 Minutes; Learning Assessment Time: 27 Minutes

Clinicians often find the hand and wrist's complex anatomy challenging to navigate, which can lead to uncertainty in differentiating arthritic conditions from ligamentous instability. This course provides structured mentorship to strengthen clinical reasoning for the distal upper extremity by linking subjective history with specific objective tests. By analyzing two distinct patient cases—one involving chronic finger stiffness and another centered on acute ulnar-sided wrist pain—participants will learn to identify structural sources of restriction and apply evidence-based intervention frameworks. By the end of this program, providers will be better equipped to decide when to use conservative management strategies, such as unloading and mobility exercises, and when to refer to a certified hand therapist for specialized care.

Learning Outcomes
  • Identify strategies for gathering a detailed patient history during a subjective examination
  • Recognize effective objective exam techniques and measures used to identify physical impairments and functional limitations
  • Outline treatment strategies observed during interventions that aim to increase patient participation in daily activities
  • Infer methods for synthesizing subjective, objective, and intervention data to support clinical decision-making
  • Match evidence-based research findings to specific patient cases observed in clinical practice

Meet your instructor

A smiling man with short dark hair and a beard wears a light blue shirt, shown on a plain gray background for medbridge.

Jared Vagy

Jared Vagy received his doctorate in physical therapy (DPT) from the University of Southern California (USC) and completed a one-year residency in orthopedics and a one-year fellowship in movement science. Dr. Vagy is a clinical associate professor of physical therapy in the DPT program at USC and is a mentor in both the…

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Chapters & learning objectives

Introduction

1. Introduction

This chapter lays the groundwork for the case presentation process by introducing the framework and preparing you for the upcoming patient cases.

Case #1: Lena

2. Case #1: Lena

This chapter examines the case of a 80-year-old female with chronic interphalangeal joint stiffness to differentiate between osteoarthritis and rheumatoid arthritis. Learners will observe objective testing techniques, including the Bunnell-Littler test, to distinguish between capsular and intrinsic muscle restrictions.

Case #2: Stephen

3. Case #2: Stephen

This chapter focuses on a 27-year-old patient with ulnar-sided wrist pain following a traumatic fall to investigate potential triangular fibrocartilage complex (TFCC) or lunotriquetral sprains. Participants will analyze provocative maneuvers and weight-bearing tests to develop a tiered rehabilitation program centered on joint unloading and progressive stability.

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