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Injuries to the Elbow, Forearm, Wrist & Hand. Bones and Joints of the Elbow Bones Humerus Radius Ulna Joints Humeroulna = humerus & ulna Humeroradial.

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Presentation on theme: "Injuries to the Elbow, Forearm, Wrist & Hand. Bones and Joints of the Elbow Bones Humerus Radius Ulna Joints Humeroulna = humerus & ulna Humeroradial."— Presentation transcript:

1 Injuries to the Elbow, Forearm, Wrist & Hand

2 Bones and Joints of the Elbow Bones Humerus Radius Ulna Joints Humeroulna = humerus & ulna Humeroradial = humerus & radius Radioulna = radius & ulna

3 Nerves of the Elbow 3 Nerves of the Elbow –Radial –Median –Ulnar

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5 Medial ViewLateral View

6 ROM for Elbow Joint Tests for Active Range of Motion ROM test for flexion ROM test for extension ROM test for elbow supination ROM test for elbow pronation Manual Muscle Tests for Elbow Biceps, Triceps, Pronators, Supinators

7 Injuries to the Elbow & Forearm Fractures Mechanism of injury 1. falling on outstretched hand 2. direct blow Usually affect lower end of humerus Treatment 1. Splint and send to ER

8 Olecranon Process Fracture

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10 Injuries to Elbow & Forearm Dislocation/Subluxation Mechanism of Injury 1. Falling on an outstretched arm 2. Limb is twisted severely Rollerblading, football, skateboarding, hockey carry increased risk Treatment 1. Immobilize and send to ER 2. Do not attempt to reduce

11 Elbow Dislocation

12 Injuries to Elbow & Forearm Sprains Mechanism of Injury 1. Hyperextension at elbow Stress Tests for Joint Laxity 1. Valgus – apply lateral force (open joint up medially) tests for laxity of ulnar collateral ligament 2. Varus - apply medial force (open joint up laterally) tests for laxity of radial collateral ligament Perform both tests with elbow straight and 30°

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14 Injuries to Elbow & Forearm Impingement – pinching of soft tissue such as bursa, tendon, or nerve between the ends of 2 bones (Ulnar Nerve) Mechanism of Injury 1. Repeated stress 2. Direct blows Special Test 1. Tinels Sign – tap the ulnar nerve, tingling down arm indicates + sign

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16 Injuries to Elbow & Forearm Bursitis –Olecranon bursitis most common –Symptoms include pain, swelling, point tenderness –Treat with ICE technique

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18 Injuries to Elbow & Forearm Biceps Brachii Rupture Mechanism of injury 1. Pulling motions (gymnastics, rowing, weight lifting Symptoms 1. Pain 2. Swelling (bulge in biceps) 3. Loss of motion/strength Treatment 1. Immobilize & send to physician

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22 Injuries to Elbow & Forearm Epicondylitis –Inflammation of the medial or lateral epicondyle of the humerus. Lateral Epicondylitis 1. affects extensors 2. called tennis elbow Medial Epicondylitis 1. affects flexors 2. called little league elbow or golfers elbow

23 Epicondylitis Mechanism of Injury 1. Chronic overuse of athletes who twist forearm during throwing or swinging Symptoms 1. pain & tenderness around elbow 2. twisting motion will cause pain Treatment 1. RICE 2. brace

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25 Injuries to Elbow & Forearm Volkmanns Contracture –Damage to muscles of forearm due to injury to blood supply Mechanism of injury 1. fracture, dislocation, muscle spasm, or swelling reduces blood supply Treatment 1. Activate EMS

26 Anatomy of Wrist and Hand Bones Wrist –8 carpal bones Hand –5 metacarpals –5 phalanges Muscles Flexors (anterior side) –Flexor carpi radialis –Flexor carpi ulnaris Extensors (posterior side) –Extensor carpi ulnaris –Extensor carpi radialis longus

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28 AnteriorPosterior

29 Injuries to Wrist and Hand Carpal Tunnel Syndrome –Inflammation of the median nerve of wrist/hand

30 Injuries to Wrist and Hand Fractures –Mechanism of injury 1. Direct blows 2. Falling on outstretched hand –Colles Fracture – distal radial fracture –Navicular Fracture – navicular (schaphoid) bone of wrist Pain in the anatomical snuff box Slowest healing bone in body (low blood supply)

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35 Injuries to Wrist and Hand Dislocation/Subluxation –Mechanism of injury 1. direct blow from a ball or other object

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38 Injuries to Wrist and Hand Sprains –Wrist sprains caused by hyperextension or hyperflexion –Thumb (Gamekeepers thumb) Sprain of ulnar (medial) collateral ligament Caused by abduction of thumb Gamekeepers Thumb Test – application of valgus stress on thumb joint

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40 Injuries to Wrist and Hand Impingement (median or ulnar nerve) –Caused by repeated stress –Phalens Test 1. Place athletes hands back to back 2. Grasp palms with one hand 3. Tingling or numbness + sign

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42 Injuries to Wrist and Hand Tendonitis –Caused by overuse –Finkelsteins Test (thumb tendon) 1. make a fist with thumb under fingers 2. place hand around athletes fist 3. apply isometric resistance as they flex in an ulna direction

43 Injuries to Wrist and Hand Mallet Finger (baseball finger) –Flexion of the distal phalangeal joint –Caused by direct blow to outstretched finger –Tears extensor tendon –Cant actively extend finger –Splint & refer to physician

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46 Injuries to Wrist and Hand Boutonniere Deformity –Abnormal contracture of phalange where proximal joint flexes and distal extends due to tendon rupture

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