Elbow and Forearm Injuries
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Transcript Elbow and Forearm Injuries
Elbow and
Forearm Injuries
Taelar Shelton, MS, ATC, AT/L
Contusions
Soft tissue or bone contustions
Usually on the medial aspect
MOI- collision, repeated
blows
Acute contusions- pain,
swelling, hematoma
Chornic- scars and bony
callus
Treatment- RICE, protection,
may need x-ray if serious
Olecranon Bursitis
Most common bursitis in the
elbow
Superficial location
Acute or chronic- direct
blow MOI
S&S- pain, warm, point
tender, swelling
Try conservative Rx firstcold compression
Aspiration if serious
Strains
Muscles around elbow
Excessive restrictive ROM
Usually from a fall or repeated microtraumas
X-ray to r/o avulsion or epiphyseal Fx
RICE, rehabilitation exercises, theraputic ultrasound,
cryotherapy (ice)
Sprains
Ligaments around the elbow
Usually from hyperextension of elbow joint
S&S- pain, shifting of elbow joint, click/pop/snap,
crepitis, tender to palpation, swelling, decrease in
function of elbow
Cold compress, main concern is ROM, do not massage,
taping may assist in protecting injury
Lateral Epicondylitis
“Tennis Elbow” is
inflammation of extension
muscles at the lateral
epicondyle
Repetitive extension of the
wrist, throwing, microtrauma
S&S- pain during
flexion/extension exercises,
pain may radiate down the
arm, mild swelling, point
tenderness
RICE for actue tendonitis,
chronic- bracing or taping and
rehab
Medial Epicondylitis
“Golfer’s Elbow” is
inflammation of the flexor
tendons at the medial
epicondyle
Repetitive flexion of the
wrist, pitching, golf swing
Same Rx as tennis elbow
Osteochondritis Dissecans
OCD also occurs in the knee
Occurs in the bone and
articular cartilage
Impariment of blood supply,
causes loose bodies in the
joint
“Locking” joint
Can require surgery
Can lead to arthritis
Ulnar Nerve Injuries
Ulnar nerve is involved
MOI- friction due to valgus
force at elbow
Can be caused by
impingment at the elbow
S&SS- parasthesia down
ulnar side of forearm,
numbness and tingling
Rx- Avoid pressure, can
require surgery
Dislocation of the Elbow
FOOSH is a common MOI
Can dislocate anteriorly,
posteriorlly or laterally
Olecranon deformity
Many ligmaents and
tendons can be involved and
may also cause a Fx
Referral imediately,
reduction by MD, sling,
immobilize in flexion, rehab
Fractures- Elbow
Humerus, radius or ulna
Usually a FOOSH or direct
blow MOI
Higher rate of injury in
children
S&S: discoloration, swelling,
muscle spasm, bone
displacement is possible,
swelling and muscle spasm
Referral for X-ray
Volkman’s Contracture
Complication of a serious injury
Causes blood flow problems
S&S: pain, swelling, muscle spasm, pressure
Leads to permanaent muscle contracture and permanent
paralysis in servere cases
Immediate referral
Wrist/Hand Injuries
Colles’ Fx
Fracture to the distal radius
FOOSH, hyperextension
Visible deformity
Ligaments are usually
involved
Splint and get an xray
Carpal Tunnel Syndrome
Anterior aspect of the wrist
Transverse ligament can be
too tight
Usually overuse but can be
from a direct blow
Limited space for structures
S&S: complain of
numbnress and tingling
de Quervain’s
Tendosynovitis
Synovial lining becomes
inflammed
Constant wrist movement
makes this worse
S&S: aching, radiating pain
in the forearm, pain with
extension of the thumb, may
hear a snap with movement
Rx: imobilize, ice, rest,
antiinflammatory
medications
Scaphoid Fx
Most common carpal bone
fracture
FOOSH
Can be misdiagnosed as a
sprain
Poor blood supply to this
bone- can lead to necrosis
Need to get an xray and
imoblize
Hamate Fx
MOI: from the handle of a
golf club, tennis racquet or
baseball bat
S&S: wrist pain, weakness
Usually needs to be casted
Wrist Ganglion
Herniation of the joint
capsule or synovial sheath
of a tendon
Can aslo be a cyst
Occurs after a wrist sprain
that did not get proper Rx
Rx: Apply a pressure pad,
surgical removal or draw the
fluid out
Lunate Dx
Most common bone to
dislocate of the carpal bones
Usually dislocates anteriorly
Deformity on the palmar
aspect
Murphy’s sign
Reduction by a physician