Transcript Elbow, Forearm, Wrist & Hand

Elbow,
Forearm, Wrist
& Hand
Dislocated Elbow
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Def: Dislocation of the radius and/or
ulna. Usually it is a posterior dislocation
of both bones.
MOI: A fall on the outstretched arm
with the elbow hyperextended or a
severe twist with the elbow flexed.
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S/Sx: Severe pain and disability. Obvious
deformity. Profuse hemorrhage and
swelling. Complications include: injury to
the median and radial nerves and to the
major blood vessels and arteries.
Tx: Apply cold and pressure immediately,
then a sling and refer to a doctor. Reducing
an elbow dislocation should never be
attempted by anyone other than a physician.
Olecranon Bursitis
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Def: inflammation of the olecranon
bursae of the elbow
MOI: fall on or blow to the tip of the
elbow
S/Sx: obvious localized swelling
Tx: ice, rest, NSAIDs and protective
padding
Epicondylitis
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Medial epicondylitis:
Def: inflammation of the origins of
the flexors at the medial
epicondyle
MOI: repetitive forceful flexion of
the wrist
Also known as pitcher’s elbow or
little league elbow
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Lateral epicondylitis
Def: inflammation of the origin of
the extensors at the lateral
epicondyle
MOI: repetitive forceful extension
of the wrist
Also known as tennis elbow
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S/Sx: pain over the attachment point
and pain with either wrist flexion
(medial epicondylitis) or wrist
extension (lateral epicondylitis)
Tx: rest, NSAIDS, ultrasound
Brace or tape below the elbow
joint
stretch
Colles’ Fracture
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Def: A fracture to the distal end of the
ulna and/or radius.
MOI: A fall on the outstretched hand,
forcing the radius and ulna backward and
upward
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S/Sx: In most cases there is forward
displacement of the radius that causes
deformity of the wrist. Positive percussion
and compression test.
Tx: Apply ice, splint the wrist and refer to
a doctor. Athlete will be out 1-2 months.
Mallet Finger
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Def: An avulsion of the extensor tendon
usually along with a piece of bone.
MOI: Common in sports, particularly
baseball and basketball. Caused by a blow
to the tip of the finger.
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S/Sx: Inability to extend the tip of the
finger DIP joint (distal interphalangeal
joint)
Tx: Ice, x-ray and splint the joint in
extension
Boutonniere Deformity
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Def: A rupture of the extensor tendon of
the middle phalanx.
MOI: A blow to the tip of the finger.
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S/Sx: The athlete complains of severe
pain and the inability to extend the PIP
(middle) joint. The PIP joint is fixed in
flexion and the DIP (end) joint is fixed in
extension.
Tx: Apply ice and splint finger with the
middle joint in extension. Refer to a
doctor.
Jersey Finger
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Def: Rupture of flexor digitorum
profundus tendon off distal phalanx
MOI: most often occurs in the ring
finger when the athlete tries to grab
the jersy of an opponent
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S/Sx: DIP joint is fixed in extension,
inability to actively flex DIP joint, can
passively flex it, pain and point
tenderness over distal phalanx.
Tx: Tendon needs to be surgically
repaired or athlete will never be able
to flex DIP joint. Rehab lasts
approximately 12 weeks.
Gamekeeper’s Thumb
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Def: A sprain of the ulnar collateral
ligament of the MCP joint of the thumb.
MOI: A forceful abduction of the thumb,
occasionally combined with
hyperextension of the thumb.
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S/Sx: Point tenderness over the ulnar
aspect of the MCP joint. Pain with or
inability to grip. Positive valgus stress
test.
Tx: RICE, NSAIDs, splint the thumb
close to the hand. In cases of severe
disability refer to a doctor.
Dislocated Finger
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Def: A dislocation of any joint in the
finger. Usually, the first of second joint
is displaced dorsally.
MOI: A blow to the finger, usually
directed from the palmar side upward.
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S/Sx: Obvious deformity. Inability to
move injured joint.
Tx: Dislocations may be reduced
without doctor referral. After
reduction, ice and a splint should be
applied. If a fracture or tendon rupture
is suspected refer to a doctor.
Note: never reduce a dislocated thumb!
Navicular fracture
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Def: fracture of the navicular/scaphoid
bone. Most commonly fractured carpal
bone
MOI: fall on an outstretched hand
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S/Sx: often appears to be a wrist
sprain. Increased pain with
palpation in the anatomical snuff
box. Swelling in anatomical snuff
box. Pain when pressure is applied
to long axis of thumb
Tx: ice, immobilize, refer to doctor.
Cast for about 4 months
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Complications:
The scapoid has a poor blood
supply
If not immobilized properly part of
the bone will not heal
That part of the bone will die due
to avascular necrosis
May result in arthritis
Just Because It
Looks Cool
Open Dislocation of Thumb
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Def: Dislocation of thumb which breaks
the skin.
MOI: Direct blow to the thumb.
S/Sx: Pretty obvious
Tx: Reduce the dislocation using sterile
gloves. Place sterile gauze over injury and
send immediately to a doctor.