The Treatment of the Pediatric Hand Patient: Part I

The Treatment of the Pediatric Hand Patient: Part I
January 17, 2016

Pediatric Hand Patients

Pediatric hand patients can span anywhere from birth to the age of 18.  Most of my talk will focus on the younger pediatric patient, because teenage patients are very similar to adult patients, as far as how you are going to treat them and the protocols that you are going to use.  However, the younger pediatric patients (infant to about age 12) are very different. 

They are smaller and have a different body composition than adults.  As you know, pediatric patients’ hands and forearms are pudgy which can greatly affect treatment and splints.  They do not yet have their defined bony landmarks, so your evaluation is definitely altered.  They have a limited attention span, if they have any attention span at all.  They have limited understanding, so they are not going to follow directions the same way that an older child or an adult would.  Most of all they are fearful.  They are fearful of strangers.  They are fearful of the unknown.  They do not know what you are going to do.  Your whole treatment approach is going to be different with this population.

Pediatric patients also do not sit still.  You are always working with movement, which can make splinting, wound care, and exercises very difficult.  However, the pediatric patient does not get as much resultant stiffness.  They have a much higher rate of collagen in their body.  You can immobilize them for four, five, to six weeks and they will still come out with great motion and without getting the stiffness that an older child or an adult would get.  They also heal quickly.

With this population, you must deal with the parents or caretakers.  A child is not going to follow your instructions.  Their home setting is very important and to understand who is going to be taking care of them.  Is it a parent?  Do they go to daycare every day?  Do you need to work with the daycare worker?  Do they go to school?  Who is responsible for that child? 

They also have developing systems.  You need to understand normal development for muscle, neurological, skeletal, cognitive, and language development.  You need to have a great grasp of this population. You need to know their cognitive and language level in order to communicate effectively with the child.

Related Courses

Temporomandibular Joint-Anatomy/Physiology
Presented by Lori Steinley, PT, MS
Recorded Webinar
Course: #10712 Hours
This course is designed to familiarize participants with the anatomy/physiology of the temporomandibular joint.

Temporomandibular Joint-Physical Therapy Assessment and Treatment.
Presented by Lori Steinley, PT, MS
Recorded Webinar
Course: #10722 Hours
Please note: This course is also offered in a series of recordings titled "The Temporomandibular Joint", course 1416.

This course is designed to instruct participants in the physical therapy assessment and treatment of the temporomandibular joint-including discussion of modalities, manual techniques and home exercises.

Nerve Transfers
Presented by Marie Pace, M.H.S., OTR/L, CHT
Recorded Webinar
Course: #25411 Hour
Please note: This course is also offered in a series of recordings titled "Series: Hand Anatomy, Transplants and Nerve Transfers", course 1542 which is offered for AOTA/0.3 and NBCOT/3.75.

Recent innovations have made it possible to transfer part of a nerve from one location and move it to another, restoring sensory and motor function before primary nerve regeneration could restore function. This seminar will help the therapist responsible for rehabilitation to understand how recovery occurs and how to establish a treatment plan.

Introduction to Tuberculosis
Presented by Nannette Hanlin, RN
Recorded Webinar
Course: #21301 Hour
According to the Centers for Disease Control (CDC), nearly 1/3 of the world’s population is infected with tuberculosis (TB) and it is considered one of the world’s deadliest diseases. We will define TB and discuss treatment, prevention, and strategies utilized when working with a patient with TB.

Alzheimer’s 101: A Practical Overview for Health Care Professionals
Presented by Megan L. Malone, M.A. CCC-SLP, Jennifer Loehr, M.A. CCC-SLP
Course: #18162 Hours
This 2-hour course will provide the health care professional with the most essential and practical knowledge about Alzheimer’s disease. Differences between normal aging and dementia, causes of Alzheimer’s, treatment trends, management of behavioral issues and family counseling/education will be highlighted in this course.