Performing Arts Medicine, 3rd ed.Medical Problems of Performing Artists

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The Instrumentalist's Arm and Hand - Surgery and Rehabilitation

Ian Winspur, Joan Warrington
From: Performing Arts Medicine, 3rd ed.: Chapter 12 © 2010; page: 229

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Abstract: Experience shows that only 4% of musicians' hand and arm problems require surgery. By far, the commonest reason is trauma, car accidents, accidents at home, and sporting injuries. The second area involves specific focal degenerative or overuse conditions. This chapter reviews the role of surgery and subsequent rehabilitation in the treatment of musicians' injuries, exploring the surgical evaluation, indications, and modifications to surgical technique (e.g., anatomical restorations, incision sites), and results from large surgical series in musicians.
Following trauma in a musician, every effort should be made to achieve a primary anatomical repair and stable fixation that allows early mobilization. Achieving traditional hand therapy goals following trauma is essential, but with the musician-patient, additional goals and treatment approaches are required, focusing on a specialized, multidisciplinary, instrument-focused rehabilitation. Hand therapy goals include early return to modified playing, instrument-specific range of motion exercises, sensory re-education using the instrument, and strengthening and fitness exercises. Specific surgical conditions are discussed: fingertip injuries, malunion, nerve compression syndromes, swellings and ganglion, tendinopathies (including de Quervain's tendinitis), Dupuytren's contracture, enthesopathies, degenerative conditions and arthritis, and nonspecific arm pain.

Last Updated: 5 / 2010

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