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Muscle and Bone Injuries Jennifer L. Doherty, MS, ATC, LAT, CIE Academic Program Director, ATEP Florida International University Management of Medical Emergencies
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Introduction Muscle and Bone injuries are often painful but rarely life threatening When not recognized, muscle and bone injuries may have serious consequences Some muscle and bone injuries could result in permanent disability
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Musculoskeletal System Review 206 bones in the body Bone consists of hard, dense tissue Contain blood vessels and nerves Functions: Protection Locomotion
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Musculoskeletal System Review Over 600 muscles in the body Skeletal muscles attach to bones Contain blood vessels and nerves Function to produce movement via contraction/relaxation
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Common Signs and Symptoms Pain Swelling Deformity Discoloration Loss of function Audible “pop” or “snap” Call 911 immediately if the injury…. Involves protruding bone fragments Impairs breathing Involves multiple muscle and bone injuries
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General Treatment R est I ce C ompression E levation
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General Treatment Treat serious injuries as if there is a possible fracture Immobilization
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Bone Injuries Comminuted Fracture 3 or more fragments MOI: Hard, direct blow Fall in awkward position
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Bone Injuries Depressed Fracture Often occurs in flat bones MOI: Falling on hard, immovable surface Hit with a hard object
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Bone Injuries Greenstick Fracture Incomplete break Occurs in immature bone that has not completely ossified
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Bone Injuries Impacted Fracture Bone is compressed MOI: Fall from a height Immediate splinting and traction are required
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Bone Injuries Longitudinal Fracture Bone splits along its length MOI: Jumping from a height
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Bone Injuries Oblique Fracture Twisting injury MOI: Twisting on end of the bone while the other end is stabilized
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Types of Fractures Serrated Fracture Two bone fragments have a sawtooth, sharp-edged fracture line MOI: Direct blow Extensive internal damage may result Severed blood vessels and/or nerves
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Types of Fractures Spiral Fracture S-shaped separation of bone MOI: Foot is firmly planted and the body is rotated in the opposite direction
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Bone Injuries Transverse Fracture Straight fracture line at a right angle to the bone shaft MOI: Direct blow
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Bone Injuries Contrecoup Fracture Fracture that occurs on the side opposite of the trauma site
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Bone Injuries Stress Fracture Exact MOI is unknown Possible MOIs: Overload caused by muscle contractions Altered stress distribution in bone due to muscle fatigue Change in ground reaction forces Performing rhythmic, repetitive movements
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Bone Injuries Treatment of Bone Injuries When in doubt, treat the injury as a possible fracture Splint and support to prevent further injury Refer
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Muscle Injuries Contusions Acute muscle injury MOI: Direct blow S/S Hematoma Pain Ecchymosis First degree Mild ↓ in ROM Second degree Moderate ↓ in ROM Third degree Severe ↓ in ROM
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Muscle Injuries Strain Stretch, rip, or tear in a muscle or tendon MOI: Too forceful a contraction Overstretching
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Muscle Injuries First Degree Strain S/S Local pain Minor loss of strength Mild edema Mild ecchymosis Second Degree Strain S/S Impaired muscle function Moderate loss of strength Moderate edema Moderate ecchymosis
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Muscle Injuries Third Degree Strain S/S Loss of muscle function Palpable defect in the muscle Severe loss of strength Severe edema Sever ecchymosis
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Muscle Injuries Muscle Cramp/Spasm A painful involuntary contraction MOI: Lack of salt or other minerals Muscle fatigue Trauma
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Muscle Injuries Acute Onset Muscle Soreness Over-exertional muscle problem MOI: Impeded circulation causing ischemia Lactic acid and K+ build-up S/S subside immediately after exercise has ceased
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Muscle Injuries Delayed Onset Muscle Soreness (DOMS) Over-exertional muscle problem MOI: Muscle fiber damage S/S increase in intensity for 2-3 days after exercise S/S usually subside within 7 days
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Muscle Injuries Treatment R est I ce C ompression E levation
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Joint Injuries Sprain Injury to ligamentous or capsular tissue A tendon may also be involved MOI: Overstretching and tearing of ligamentous or capsular tissue
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Joint Injuries First Degree Sprain S/S Mild pain/point tenderness Mild ↓ in function Little or no edema Normal ROM
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Joint Injuries Second Degree Sprain S/S Moderate pain/point tenderness Moderate ↓ in function Moderate edema Slight-to-moderate joint instability
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Joint Injuries Third Degree Sprain S/S Severe pain/point tenderness Severe ↓ in function Severe edema Severe joint instability May involve a spontaneously reduced subluxation
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Joint Injuries Treatment for Sprains R est I ce C ompression E levation Therapeutic rehabilitation Surgery
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Joint Injuries Dislocation Result due to forces that cause the joint to go beyond its normal anatomical limits Two classes: Subluxations Luxations
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Joint Injuries Subluxation Partial dislocation Incomplete separation between 2 articulating bones
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Joint Injuries Luxation Complete dislocations Total separation between 2 articulating bones
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Joint Injuries S/S of Dislocations Loss of limb function Deformity Edema Point tenderness May involve damage to the ligamentous and tendinous tissues surrounding the joint
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Joint Injuries Treatment of Dislocations First time dislocations should be treated as a possible fracture Splint and support to prevent further injury Refer
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