b'Education REACH: April 2021Clinical PearlsIn this section we will feature a few clinicalIf you have a monofilament pearls which should bewhich has bent, place filament applicable to most handin hydrocollator for a few therapists. seconds to unbend.Paige E Kurtz, MS, OTR/L, CHTWe welcome your ideas. Jeff Cowdry, OTR/L, CHT, USAUse a thermoplastic buddy for stable digital or metacarpal fractures or as a step down from controlled mobilisation splinting. Use a thin thermoplastic and ensure skin creases are clear for full flexion. Allow position of slight abduction in finger extension and comfortable full fist. I use this exercise for stabilitySarah Mee,and control of the thumb, toConsultant Hand Therapist, encourage opposition andChelsea and Westminster activity in the first dorsalHospital, London, UK To make ice for massage at interossei.Take a table tennishome, take a styrofoam cup, ball and write numbers on italmost fill with water and place randomly.Ask the patient toin freezer.Use a box cutter / move their thumb up the numbersEmail us Stanley knife to carefully cut sequentially. away the base and top.Sarah Ewald, Clinical SpecialistPlease send a picture andPaige E Kurtz, MS, OTR/L, CHTHand Therapist, Zurich,a short description toJeff Cowdry, OTR/L, CHT, USASwitzerland. secretarygeneral@ifsht.orgTo maximise the action of pronator quadratus and thereby improve distal radioulnar joint stability, do active pronation and supination with the elbow fully flexed. This reduces the action of pronator teres and other elbow muscles. Hold a water bottle to add proprioception to improve sensorimotor feedback in unstable wrists .Sarah Mee,Consultant Hand Therapist, Chelsea and Westminster Hospital, London, UK8'