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Elbow/Wrist/Hand Unit

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Presentation on theme: "Elbow/Wrist/Hand Unit"— Presentation transcript:

1 Elbow/Wrist/Hand Unit
Chapter 22 Advance Sports Medicine

2 Anatomy Of The Elbow/Wrist/Hand
1. Navicular (scaphoid) 2. Lunate 3. Triquetral 4. Pisiform 5. Hamate 6. Capitate 7. Trapezoid 8. Trapezium 9. Ulnar styloid 10. Radial Styloid

3 Anatomy cont. Bones of the elbow 1 Olecranon 2 Capitulum- 3 Trochlea
4 Lateral epicondyle 5 Medial epicondyle

4 Muscles and Ligaments of the forearm/elbow
Ligaments of elbow 11.Extensor carpi ulnaris 12. Extensor carpi radialis 13. Flexor digitorum 14. Extensor digitorum 15. Thumb- 16. Flexor pollicis longus/brevis 17. Extensor pollicis longus/brevis 18. Abductor pollicis 19. Adductor pollicis 20. Opponens pollicis 21. Opponens digiti minimi (5th phalange Ulnar collateral Radial collateral Annular lig.- attaches to ulna/radius of the elbow Muscles 4. Biceps brachii 5. Tricep brachii 6. Brachial radialis 7. Supinator 8. Pronator teres 9. Flexor carpi radialis 10. Flexor carpi ulnaris

5 Thenar And Hypothenar Eminence
Thenar eminence: thumb side Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis Hypothenar eminence: pinky side Opponens digiti minimi Abductor digiti minimi Flexor digiti minimi brevis

6 Injuries to elbow Contusions Olecranon bursitis Strains
May swell rapidly after an irritation of the olecranon bursa or the synovial membrane R I C E Olecranon bursitis Most frequently injured bursa in the elbow. Pain, point tenderness, severe swelling Ice and compression and possibility of aspiration Strains Usually caused by falling on an outstretched arm or hyperextension. Test the biceps, triceps, brachialis, pronators, supinators

7 Elbow Injuries cont. Sprains Lateral epicondylitis
Caused by hyperextension or valgus forces. Point tender of the ulnar collateral lig. Ice, compression and sling with the elbow in 45 degrees of flexion Lateral epicondylitis Chronic, or called tennis elbow, caused by repetitive microtrauma to the insertion of the extensor muscles, Hyperpronation is the primary action. RICE, and NSAID’s Medial epicondylitis same as above but most common in pitching, wrist flexors

8 Elbow injuries cont. Osteochondritis Dissecans Little League elbow
Loose body in the joint, young athletes yrs old. Sudden pain and locking of the joint RICE, NSAID’s, possible surgery Little League elbow Occurs in 10-25% of young pitchers, Injury onset is usually slow, may have joint tightness and triceps weakness, decreased ROM in pronation and supination RICE,NSAID’s and throwing is stopped. Cubital tunnel syndrome Ulnar nerve tunnel, traction injury from valgus force, irregularities within the tunnel, subluxation of the ulnar nerve because of a lax ligament, or a progressive compression of the ligament on the nerve.

9 Posterior Elbow dislocation

10 Elbow Dislocation Elbow Injuries cont.
Fall on an outstretched hand with elbow in a hyperextension or twisted position Deformity with olecranon extending backward beyond its normal alignment Rupture most of the stabilizing ligaments Profuse swelling, pain and disability Complications can include injury to major nerves and blood vessels Rx: splint and refer to Dr. immediately for reduction as soon as possible.

11 Elbow Injuries cont. Elbow Fracture Etiology: fall on an outstretched arm or a direct blow to the olecranon. Fracture site: just above the epicondyles of the humerus S/S: may or may not have visible deformity, will have hemorrhage, swelling, muscle spasm Rx: splint, ice and send to Dr. One complication is decreased ROM

12 Volkmann’s contracture
humeral supracondylar fx, which cause muscle spasm, swelling, or bone pressure on the brachial artery, inhibition blood circulation to the forearm, wrist, and hand S/S: pain in the forearm which becomes greater when the fingers are passively extended. Brachial/radial pulses diminish which produce cold hands Rx: remove bandages and elevate to relieve the pressure. Dr.

13 Eval. Of elbow History: Observation Palpation
Is it caused by direct trauma, throwing type of an inj?, look for internal organ problem or ulnar nerve impingement, is there is a feeling of locking or crepitation? Observation Carrying angle, see if the bony prominence form an isosceles triangle with the elbow at 45 degrees. Palpation Special tests: see Handout

14 Rehab of the elbow Stage 1 Stage 3 Stage 2 Maintain CV RICE
Early splinting and Interferential for the pain along with NSAID’s Stage 2 Maintain CV Early ROM exercises Joint mobilizations for increase ROM Closed kinetic chain exercises PNF exercises Strengthening exercises after full ROM is obtained Stage 3 Functional progression Open kinetic chain ex. W/controlled ROM Open kinetic chain ex. Through pain free ROM PNF/closed kinetic ex. Sports specific exercises.

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