1. Recognition and Management of Elbow Injuries

2. Olecranon bursitis
Cause: result of direct blow; superficial location makes it prone to injury
S&S: 
Care: ice packs, compression, padding, possible aspiration

3. Elbow strains
Cause: excessive resisted motion such as a fall on outstretched hand with elbow in extension that forces joint into hyperextension
S&S: pain with active and resistive movement, point tenderness in muscle, tendon or muscle belly
Care: RICE; rehab, modalities, x-ray if loss of motion

4. Ulnar Collateral Ligament Injuries
Cause: valgus force from repetitive trauma
S&S: medial elbow pain, tenderness over UCL, laxity
Care: Rest, rehab: strengthening, modalities, correct throwing mechanics, possible surgery “tommy john”

5. Epicondylitis
Cause: repeated forearm flexion and extension movements; small micro-tears at muscle attachments
S&S: pain at epicondyles during forced wrist flexion/extension; radiating pain, point tenderness, mild swelling
Care: rest, modalities for pain, rehab, brace

6. Elbow dislocation
Cause: fall on outstretched arm with elbow in hyperextension, twist with elbow in flexion
S&S: 
Care: call 9-1-1, referral for reduction, sling, ice

7. Little League Elbow
Cause: occurs in 10-25% young pitchers; caused by repetitive microtrauma that occurs from throwing and not from the type of pitch thrown; includes many disorders of growth in the pitching elbow that may include:
an accelerated apophyseal growth region plus a delay in the medial epicondylar growth plate
A traction apophysitis with a possible fragmentation of the medial epicondylar apophysis
An avulsion of the medial epicondyle of the radial head
Osteochondrosis of the humeral capitellum
A nonunion stress fx of the olecranon epiphysis

8. S&S: onset is usually slow, in the beginning the athlete may have a flexion contraction, with tightness of anterior joint capsule and weakness of triceps muscle, complains of locking or catching,  ROM of forearm supination/pronation
Care: RICE, NSAIDs, no throwing until full ROM, stretching, triceps strengthening, correct throwing techniques

9. The Forearm, Wrist, Hand and Fingers

10. Forearm Injuries Colles Fracture
Cause: fall on outstretched hand, forcing forearm backward and upward into hyperextension
S&S: deformity of wrist, profuse swelling
Care: cold, splint wrist, forearm in sling, x-ray, immobilize for 1-2 months

11. Injuries to the Wrist Sprains/Strains
Cause - sprain most common, most poorly
managed; abnormal forced movements or falling on hyperextended wrist
S&S: generalized swelling, tenderness, limited
range of motion
Care: RICE, modalities, rehab: strengthening,
taping

12. Cause: force on the outstretched hand
Scaphoid fractures
Most frequently fractured carpal bone
Without proper splinting, the scaphoid fx may have difficulty healing due to inadequate blood supply
Cause: force on the outstretched hand
S&S: same as severe sprain; swelling and point tenderness in anatomical snuffbox
Care: ice, splinting, xray, immobilization usually 6wks, rehab

13. Wrist ganglion
Cause: herniation of joint capsule or synovial sheath; usually appears slowly after wrist strains
S&S: lump, pain, feels soft, rubbery or very hard
Care: aspiration of cyst, chemical cauterization with a pressure pad, surgical removal

14. Injuries to the Hand and Fingers
Dislocations of the phalanges
Cause: force is directed upward from palmar side displacing either 1st or 2nd joint dorsally, resulting in tearing of supporting capsular tissue with hemmorhaging
S&S: deformity, pain, swelling
Care: reduction, xray, splinting

15. Gamekeeper’s Thumb (UCL sprain of MCP joint)
Cause: forceful abduction combined with hyperextension
S&S: pain over UCL, weak and painful pinch, tenderness, swelling
Care: refer to orthopedic, splint usually 3wks, rehab, taping

16. Mallet finger
Cause: force that strikes the tip of finger, avulsing the extensor tendon
S&S: 
Care: RICE, xray, splint in extension

17. Boutonniere deformity
Cause: trauma to tip of finger rupturing the extensor tendon dorsal to the middle phalanx
S&S: severe pain; inability to extend DIP joint; swelling; point tenderness; obvious deformity
Care: ice; splinting; xray