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Crps

In: Science

Submitted By bdj6
Words 394
Pages 2
CRPS in children: “a success story”
BDJ6

CRPS case study u Age

13 u Female u Hand Dominance- right u Had a fall - out stretched hand u injured her LEFT hand

On the Day of injury u went to A&E u X-ray – No # u wrist support week after u appointment @ # clinic u another X-ray ? Scaphoid, ? distal radial fracture - POP 2weeks Review in clinic u POP off and advised to use hand.

Clinic follow up After 2 Weeks (5 weeks since the original injury) u Patient

Still in excessive Pain and Not Using Left Hand for Anything u MRI – NBI

Diagnosed CRPS Referred to therapy

Relevant past history: u seen GP frequently for wrist sprains and general wrist pain - had wrist supports – u ?hyper-mobility u Ankle # 2008 Medication u paracetamol

Social: u Lives with mother, Has a 20year old sister who also had joint problems u At School u Hobbies-

Football, Rugby, Hockey, Swimming

Assessment u Posture

of upper limb, hand….. u Oedema: very mild in wrist and hand u Skin: shiny and blotchy u ROM: no problem wrist/thumb/fingers u Sensation: No sensory loss u Psychological

– Fear of pain - Would not move hand or thumb – worried about not being able to play sports. – Worried about missing out – friends and school



PRWHE u Pain

score u Functional Score Total

44 49.5 93.5

Occupational priority u To be able to hold fork u To be able to tie hair back u To be able to play sports

Treatment u Explained CRPS to patient u Twice /week u Activity based u Direct patient involvement u mother participating only to support

Treatment
Graded and activity based u Therapeutic putty u Buttons u Jumper sleeve u Homework
– Holding fork – Empty cup – Reaching hand to (tie) hair

2nd Session: Hand still painful can only use for activities for 5minutes at a time Treatment: If distracted her focus on hand pain and concentrated on the activity she was able to do the tasks.

u Gradually

tolerance u Gave patient specific activity goals that she wanted to progress to u Gave her the control on the treatment programme u Made it more of fun

increased the activity

After 6 sessions with lots of praise and encouragement patient could use her hand normally PREW score 7 on discharge I would call this a Success Story!!

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