In the emerging health care system many patients are referred to therapy primarily with the dreaded “Wrist Sprain” Diagnosis. This typically happens when a person falls or twists their wrist in such a way as to cause pain yet the X-Ray is negative for fracture. This “Diagnosis” leaves the therapist in a quandary as traditional therapy interventions typically lead to a failure to resolve the issue and an increase in symptoms. This webinar will review basic mechanics of the central wrist, subsequent pathomechanics and propose interventions that will lead to improved patient outcomes and satisfaction

Level of Instruction:  Intermediate

Course Objectives

  • Identify the basic mechanics of the proximal carpal row and it’s involvement in wrist pathology
  • Identify carpal instability patterns including DISI and VISI.
  • Define the terms SLAC wrist, S/L disassociation, SNAP wrist, Perilunate dislocation and PMCI patterns. Surgical interventions including S/L repair, 4 corner fusion and proximal row carpectomy will be reviewed.
  • Demonstrate assessment tools to distinguish among these entities.
  • Identify and present the state of evidence to support this area of practice.
  • Identify appropriate treatment interventions including orthotic management and taping techniques in pre and post surgical cases.

Course Agenda

  • Biomechanical review of basic carpal kinematics including wrist ligament function pertaining to the development of wrist instability
  • Review of wrist pathology including S/L disassociation, Perilunate dislocation, Keinbock’s disease, Scaphoid non-union and SLAC wrist development.
  • Palmar mid carpal instability: What is really happening.
  • The dart throwers motion: What is it and what promise does it hold for therapeutic intervention
  • Questions and adjourn


  • Paul J. Bonzani, OTR/L, CHT, M.H.S.

Clinical Assistant Professor University of New Hampshire Dept. of Occupational Therapy.
Throughout his career he has had the fortunate opportunity to work with some of the finest hand surgeons and therapists in the country having held management positions at both The  University of Vermont—Fletcher Allen Medical Center and Duke University Medical Center.  Additionally he has been an adjunct instructor in both the Duke University Physical Therapy Program and the Program in Occupational Science at the University of North Carolina-Chapel Hill.  Mr. Bonzani brings 22 years of clinical experience in orthopedic and industrial rehabilitation.  Paul has presented nationally in the areas of biomechanics and rehabilitation of the shoulder, nerve compression syndromes, RSI/CTD management and pain syndromes. He has published on the subjects of CTD/RSI management, thumb reconstruction, management of the rheumatoid elbow, shoulder and elbow tendonopathy, hand anatomy and nerve injuries.  Clinical specialties include rehabilitation of the shoulder, elbow, wrist and hand, chronic pain syndromes, TOS, nerve compression syndromes and neural dynamic disorders of the upper limb.  Current research interest is pain management of ulnar sided wrist pain following distal radius fractures.   Paul is a clinician, researcher, author and educator and considered to be one of the leading therapists in the care of shoulder, elbow and hand injuries in North America.


Contact Hours: 1.5

Price: $49


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