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Hand therapy in ulnar, median and radial nerve rupture; A comprehensive reference guide at Saba Occupational Therapy Center - Saba Occupational Therapy
مقاله تخصصی

Hand therapy in ulnar, median and radial nerve rupture; A comprehensive reference guide at Saba Occupational Therapy Center - Saba Occupational Therapy

3 weeks ago
998 بازدید
Maryam Nasiri

Maryam Nasiri

tehran

Occupational therapy, hand therapy

Hand therapy in ulnar, median and radial nerve rupture

Imagine that the connection between the will of your brain and the movement of your hands suddenly breaks; Where the gentle touch of a cloth is painful for you like an electric current or like a piece of wood, numb and dead. Rupture or damage to the peripheral nerves of the hand, including three main pathways, i.e. the median, ulnar and radial nerves, is one of the most complex and challenging injuries in the world of orthopedics and neurology. Nerves are the electrical message transmission cables of the brain, and when these cables are damaged by cuts, severe pressure, or crushed fractures, the hand, which is the main tool of our identity, independence, and interaction with the world, suffers a profound disability that affects not only the body, but also the psyche of the person.

Many of our clients in areas16, 17, 18, 19 and 10 of Tehran, after tragic accidents caused by working with industrial machines, cut by glass or road accidents, with a bag full of despair and anxiety. They refer to our center. Their constant question is: "Will my hand ever move again?" Can I hold my child again or go back to my job?” The scientific truth is that the body's peripheral nervous system, unlike the brain and spinal cord, has amazing regenerative power, but this power can only be achieved if the path of regeneration is guided by intelligent, continuous and scientific interventions hand therapy at home in Tehran and a specialized clinic.

📞 Direct consultation: 09351202087

In this reference article, prepared by the specialized team of best occupational therapy south of Tehran, we go beyond the boundaries of classical knowledge and introduce you to the most detailed biological, surgical and rehabilitation aspects of these injuries. Our goal beyond a simple treatment is to turn "despair" into "movement" and return "hope" to the center of your families.

Chapter one: anatomy of hand nerves; The three main pillars of performance and life

To understand the path of treatment, we must first carefully understand the geometry and role of the nerves of the forearm and hand. Our hands are under the command of three main nerves, each of which has a unique territory and functions:

1. Median Nerve; The architect of power, precision and sense

Madin's nerve through

Severe damage to Madin leads to a state called "Ape Hand"; A situation in which the thumb has lost its resistance and the person faces a serious challenge even in holding a spoon or buttoning a shirt.

2. Ulnar Nerve (Ulnar Nerve); The engineer of the subtleties of the hand and the power of grasping

This nerve that comes from the back passes through, the most sensitive nerve of the hand against impact. The ulnar is responsible for the sensation of the little finger and half of the ring finger. The strategic importance of this nerve is in controlling the small muscles inside the hand (intrinsic muscles) that enable very delicate movements such as playing the piano, fast typing, writing and opening and closing the fingers. Damage to the ulnar leads to the phenomenon of "claw hand" which not only disables the hand from a functional point of view, but also creates an unpleasant appearance that embarrasses the patient in social gatherings.

3. Radial Nerve; Open and release drive motor

The radial nerve runs on the back of the arm and forearm, and its main responsibility is to extend (open) the wrist and fingers. This nerve allows us to open our hand to grab a glass. If this nerve is damaged, the person loses the power to raise the wrist; A condition called "Wrist Drop". In this case, the hand falls down and even if the fingers are healthy, due to the poor condition of the wrist, the grip will not be effective.

Hand therapy in ulnar, median and radial nerve rupture; a comprehensive reference guide at the occupational therapy center of Saba
hand therapy in ulnar, median and radial nerve rupture; Comprehensive reference guide at Saba occupational therapy center

📞 Direct consultation: 09351202087

Chapter two: scientific classification of nerve damage; From pressure to complete disconnection

In

  1. Neuropraxia (Neuropraxia): The weakest type of injury, which is usually caused by temporary pressure (such as a strong hand falling asleep). The nerve sheath and continuity are preserved, but the transmission of the message is impaired. Recovery in this phase is usually complete spontaneously and within a few weeks.
  2. Axonotmesis (Axonotmesis): In this case, the inner fibers of the nerve (axons) are severed, but the protective sheath of the nerve is still intact. Here, the nerve must begin to grow again from the site of damage. The speed of nerve growth in the best conditions is 1 mm per day.
  3. Neurotmesis (Neurotmesis): The most severe type in which the nerve and its sheath are completely severed. Without microscopic surgery, there is no hope of returning function at this level.

Key warning signs:

  • Paresthesia and Dysesthesia: Constant burning sensation, sudden electric shocks or bone cold in the fingers.
  • Obvious muscle atrophy: Hollowing of the muscles behind the hand and severe thinning of the forearm, which indicates the interruption of nerve supply to the muscles.
  • Skin changes: Shiny skin, hand hair loss and inability to sweat which indicates sympathetic nerve involvement.

The third chapter: surgical strategies and the battle against time; The role of surgeon and occupational therapist

In complete tears, surgery (Nerve Repair) should be done as soon as possible. Using a microscope, chiropractic surgeons delicately suture nerve bundles. If the distance between the two ends of the nerve is large, a "nerve graft" (removal of the nerve from the leg) is used.

Critical point: Many patients think that the work is done after surgery. But surgery only provides the "infrastructure". If hand therapy is not started immediately, the place where the nerve is sutured will become scarred and sticky and the path of nerve growth will be blocked. Hand therapy is actually gardening that allows the seed planted by the surgeon to grow into a vigorous tree.

📞 Direct consultation: 09351202087

Chapter four: specialized protocols and step-by-step hand therapy in Saba center

Saba occupational therapy center under the management of Maryam Nasiri, implements a strict and scientific treatment protocol that includes There are three main phases:

1. Scar protection and management phase (weeks 0 to 4)

2. Phase of neural stimulation and sensory retraining (weeks 4 to 16)

  • Advanced Electrotherapy (EMS/TENS): Muscles that do not have nerves, quickly atrophy. Using electrical stimulation devices, we force these muscles to contract so that they remain alive and fresh when the new nerve arrives.
  • Sensory re-education program (Sensory Re-education): After a while, the brain forgets the sense of the damaged area. Using different stimuli (rough, soft, cold, warm), we train the brain to re-identify weak neural messages.
  • Mirror Therapy (Mirror Therapy): a scientific technique to trick the brain and stimulate the motor parts that works miracles in severe nerve damage.

3. phase of returning to performance and strength (from month 4 onwards)

  • Progressive resistance exercises: Using special occupational therapy pastes (Theraputty) and weights to restore punching strength.
  • Skill exercises: Rebuilding activities of daily living (ADL) such as tying shoes, working with locks and keys, and using mobile phones.

Chapter Five: Dangerous complications caused by negligence in treatment

Many of the respectable residents of Yaftabad, Fallah and Abu Dhar neighborhoods, who abandon treatment due to lack of knowledge, face irreparable complications:

  1. Joint Contracture:
The tendons and joint capsule are shortened and the hand is locked in a deformed position.

  • Chronic neuropathic pains: Pain that twists like a dagger in the hand and makes the patient dependent on taking heavy nerve drugs.
  • Job loss and depression: Inability to work with hands leads to livelihood problems and consequently family crises.
  • Hand therapy for rupture of the ulnar, median and radial nerves; a comprehensive reference guide at Saba occupational therapy center
    Hand therapy in ulnar, median and radial nerve rupture; Comprehensive reference guide at Saba occupational therapy center

    Sixth chapter: Why is the Saba center the main reference for your treatment?

    1. Scientific leadership

    Saba center management, Mrs. Maryam Nasiri, with years of experience in Tehran's orthopedic reference hospitals. It is believed that every hand is a work of art. His accuracy in periodic evaluations makes the smallest nerve growth not far from the eye of the treatment team.

    2. Local SEO and commitment to South Tehran

    We are proud to be the best occupational therapy in South Tehran. Quick access for the residents of Falah, Waliasr, Wesfanard and Zamzam means that the patient can benefit from quality services on a daily basis without worrying about traffic.

    3. Hand therapy at home in Tehran; Clinic in your room

    For patients who have had major surgeries or the elderly who are unable to move, we bring all clinical equipment to your home in areas 10 to 19. This reduces the patient's stress and doubles the speed of recovery.

    📞 Direct consultation: 09351202087

    Frequently Asked Questions (FAQ) with descriptive answers

    1. Why is my hand still numb after surgery? Surgery only fixes the plumbing, but the fluid (nerve message) has to grow from the suture site to the fingertips. This process is time-consuming due to the low speed of nerve growth and requires patience and hand therapy.

    2. Does smoking prevent nerve healing? Yes, strongly! Nicotine causes narrowing of the blood vessels leading to the nerve and can stop the growth of the nerve or cause surgery to fail.

    3. Is it possible that my hand will never heal? If you delay treatment or go to non-specialist centers, the possibility of permanent disability is high. But with the timely start of occupational therapy at the Saba center, most patients return to an acceptable level of performance.

    4. What is the role of nutrition in nerve repair? Consumption of group B vitamins (especially B1, B6 and B12) and omega-3 fatty acids as prescribed by the doctor helps to regenerate the myelin sheath of the nerve.

    5. How much is the cost of occupational therapy sessions? We act in accordance with the tariffs approved by the Ministry of Health, and considering the economic conditions of the southern region of Tehran, we have maximum cooperation with our dear clients. For detailed inquiries, call 02166209819.

    6. Does the splint have to be closed all the time? Yes, in the first weeks the splint acts like a plaster and protects the life of your stitched nerve. Arbitrarily opening it can tear the delicate sutures of the nerve.

    7. What exercises to do at home? Exercises are different in each stage. At the Saba Clinic, we provide you with exclusive educational videos and brochures according to the progress of the nerve.

    Conclusion: Have faith in your hands

    Nerve injury is a long journey, but every long journey begins with the first step. At Saba Occupational Therapy Center, we use not only our expertise, but our heart and soul to restore your capabilities. Don't let an incident define your future.

    Contact and appointment information (call now)

    Name of the center: Saba Occupational Therapy and Speech Therapy Center Specialty: Advanced hand rehabilitation (hand therapy) Management: Maryam Nasiri

    📞 Direct consultation: 09351202087 ☎️ Telephone for appointment: 02166209819

    📍 Address: Saeedi Highway, Fallah Three Road, Propheti St., before Shandiz Crossroad, No. 79, First Floor, Unit 2

    🔗 Read more: Educational Articles of Saba Site

    With Saba, experience movement again.

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