Work related musculoskeletal disorder (WMSD) of the wrist and hand are relatively common. In 2001, a US Department of Labor Department reported that of the 355, 344 cases of hand injuries, 33,431 were sprains and strains of the wrist and hand, 26,794 were cases of carpal tunnel syndrome. Tendinitis (tendinopathy) and trigger finger accounted for 4, 896 cases. The department states that WSMD’s of the wrist and hand are associated with the longest absences from work and are, therefore, associated with a greater loss of productivity and wages compared to other anatomical regions. (1) Based on these statistics it is apparent that an understanding of how to diagnose and treat musculoskeletal injuries of the hand is important. The purpose of this article to introduce how to integrate the approaches developed by James Cyriax and Brian Mulligan in the examination and treatment of non-surgical orthopaedic problems of the wrist and hand. Numerous non-surgicalorthopaedic conditions can occur, a few have been selected to illustrate how they are identified and may be treated. Ombregt’s textbook, System of Orthopaedic Medicine is an excellent reference for differential diagnosis.
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