Est1 Task 1

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DOI: 10/30/2015. The patient is a 51-year-old right hand dominant female system analyst who sustained cumulative trauma to both elbows and wrists/ hands from repetitive computer use. As per OMNI, the patient was diagnosed with acquired trigger fingers/thumb, de Quervain’s, bilateral elbow lateral epicondylitis and left wrist strain.
As per progress report on 6/2/16, the patient was provided with two new wrist splints and was advised to return to modified duty and work in splint as needed.
According to the progress report on 7/7/16, the patient has exhausted conservative treatment including 12/12 occupational therapy sessions 12/12 acupuncture sessions and multiple cortisone injections. The patient has been advised to continue her wrist splints, …show more content…
Of note, electrodiagnostic studies reveal no evidence of compressive neuropathy. The patient is noted to have developed long finger stenosing tendovaginitis of the left hand, and she underwent corticosteroid injection in conjunction with an injection of the left thumb. She continues to have discomfort, primarily in the left upper extremity affecting the medial and lateral epicondyles, de Quervain tendovaginitis, and stenosing tendovaginitis of the left thumb and long finger. Treatment recommendation includes surgical intervention in the form of left elbow medial and lateral epicondylectomy with soft tissue releases, left thumb A1 pulley stenosing tenovaginotomy, and left long finger A1 pulley stenosing tenovaginotomy. As per report, the patient has undergone a thorough course of conservative measures including activity modification, nonsteroidal anti-inflammatory medications, and occupational therapy, as well as corticosteroid injections. She remains symptomatic, therefore surgical intervention is
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