elbow, wrist & hand
DESCRIPTION
Elbow, Wrist & Hand. SECTA Sports Medicine. The Elbow. Bones humerus ulna radius Ligaments ulnar collateral lig . annular lig . radial collateral lig . The Elbow. Muscles triceps brachii biceps brachii brachialis Anconeus (posterior) brachioradialis. The Elbow. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/1.jpg)
ELBOW, WRIST & HAND
SECTASports Medicine
![Page 2: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/2.jpg)
The Elbow Bones
humerus ulna radius
Ligaments ulnar collateral lig. annular lig. radial collateral lig.
![Page 3: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/3.jpg)
The Elbow Muscles
triceps brachii biceps brachii brachialis Anconeus
(posterior) brachioradialis
![Page 4: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/4.jpg)
The Elbow Common injuries of the elbow:
Contusions Sprains/Strains Dislocations Fractures Nerve Injuries Epicondylitis Volkmann’s Contracture
![Page 5: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/5.jpg)
The Elbow Contusions
Common Caused by a direct blow Bleeding & bruising
Treatment RICE Protective Padding
![Page 6: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/6.jpg)
The Elbow - ContusionsNORMAL SKIN CONTUSION
![Page 7: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/7.jpg)
The Elbow Sprains
Commonly result from forced hyperextension or side to side forces
“click” or “pop” sound with sharp pain
Localized swelling & pain Arm will be held in a
flexed position
Treatment RICE Use of a specialty brace
may be suggested
![Page 8: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/8.jpg)
The Elbow Strain
Result from the high amounts of stress place on the elbow
Acute Sudden overload
Chronic Continued overuse
Treatment RICE Use of a specialty brace
may be suggested
![Page 9: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/9.jpg)
The Elbow Dislocation
The 2nd most frequently dislocated major joint
Most common- posterior displacement of the ulna Results from a fall on
an outstretched hand with the elbow hyperextended
![Page 10: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/10.jpg)
The Elbow- Dislocation Signs & Symptoms
If displaced- obvious deformity
Loss of function Considerable pain
![Page 11: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/11.jpg)
The Elbow- Dislocation Treatment
Properly immobilized
Transport to the athlete’s physician or the nearest medical facility
![Page 12: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/12.jpg)
The Elbow Fractures
Caused by direct trauma, indirect stress (falling), excessive forces (throwing)
Most common in children or skeletally immature athletes
Many involve the growth plate (epiphysis)
![Page 13: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/13.jpg)
The Elbow- Fractures Signs & Symptoms
Point tenderness Swelling Limited range of
motion Disability at the
elbow or hand Increased pain at
the fracture site when attempting movement Olecranon Process Fracture
![Page 14: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/14.jpg)
The Elbow- Fractures Treatment
Immobilization Ice Elevation Immediate referral
to medical facility
![Page 15: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/15.jpg)
The Elbow Nerve Injuries
Not as common as musculoskeletal injuries
Ulnar Nerve Contusion Cubital Tunnel Syndrome Radial Tunnel Syndrome Pronator Teres Syndrome
![Page 16: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/16.jpg)
The Elbow- Nerve Injuries Ulnar Nerve Contusion
Blow or contusion to the ulnar nerve (funny bone)
Immediate pain & burning sensation shooting down the forearm to the ring and little fingers
Depending on the severity of the blow the pain may last from a few minutes to a longer period of time
![Page 17: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/17.jpg)
The Elbow- Nerve Injuries Cubital Tunnel Syndrome
Ulnar nerve becomes trapped and compressed in the cubital tunnel (posterior aspect of the medial epicondyle groove)
Due to repetitive movement (throwing or swimming)
Signs & Symptoms Pain along inner aspect of the elbow Tenderness over medial epicondylar groove Paresthesia in distrubution of ulnar nerve in the
hand
![Page 18: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/18.jpg)
The Elbow- Nerve Injuries Radial Tunnel Syndrome
Radial nerve becomes trapped during activities requiring repetitive pronation and supination of the forearm
Sign & Symptoms Pain over lateral aspect of the elbow Tenderness over anterior radial head
![Page 19: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/19.jpg)
The Elbow- Nerve Injuries Pronator Teres Syndrome
Median nerve becomes trapped or compressed due to hypertrophy of pronator teres or repetitive pronation of the forearm
Signs & Symptoms Pain radiating down the anterior forearm Numbness, tingling in the thumb, index and
middle fingers
![Page 20: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/20.jpg)
The Elbow Epicondylitis
Chronic strain of the medial or lateral epicondyle Caused by faulty mechanics or techniques, weak
muscle groups, inappropriate equipment
Tennis Elbow Commonly given to pain on the lateral side of the elbow
Golfer’s Elbow Commonly given to pain on the medial side of the elbow
Pitcher’s Elbow, Bowler’s Elbow, Javelin Thrower’s Elbow
![Page 21: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/21.jpg)
The Elbow- Epicondylitis Signs & Symptoms
Local tenderness over epicondyle Pain with the use of the involved muscle Possible swelling
Treatment Preventive: proper equipment, proper technique,
limited stress Proper warm up and stretch RICE Modified activities
![Page 22: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/22.jpg)
The Elbow Volkmann’s Contracture
Absence of blood flow (ischemia) to the forearm From swelling, fracture, burns, excessive
exercise, injections in the forearm, animal bites
Muscles on the palm side of the forearm shorten Causes the fingers to form a fist and flex toward
the wrist
Mild, Moderate, Severe
![Page 23: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/23.jpg)
The Elbow- Volkmann’s Contracture
Signs & Symptoms Severe pain when muscle is passively moved Swollen Shiny Pain when forearm is squeezed Pain gets worse with time Decreased sensation Weakness Paleness of the skin
![Page 24: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/24.jpg)
The Elbow- Volkmann’s Contracture
![Page 25: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/25.jpg)
The Wrist & Hand Bones
Ulna Radius Carpals Metacarpals Phalanges
![Page 26: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/26.jpg)
The Wrist & Hand Muscles
Hand Supinator Pronator teres Pronator quadratus
Thumb Flexor pollicis longus Flexor pollicis brevis Extensor pollicis longus Extensor pollicis brevis Adductor pollicis Abductor pollicis longus Abductor pollicis brevis Opponens pollicis
Fingers Flexor digitorum
profundus Flexor digiti mimimi
brevis Interossei dorsalis Flexor digitorum
superficialis Extensor indicis Interossei palmaris Abductor digiti minimi Oppenens digiti minimi Extensor digitorum
communis
![Page 27: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/27.jpg)
The Wrist & Hand
![Page 28: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/28.jpg)
The Wrist & Hand
![Page 29: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/29.jpg)
The Wrist & Hand Fractures
Boxer’s Fracture Baseball (Mallet) Finger Jersey Finger Scaphoid Fracture Colles’s Fracture
![Page 30: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/30.jpg)
The Wrist & Hand- Fractures
Boxer’s Fracture A break in the 5th
metacarpal leading to the little finger
Caused by slamming a clenched fist against a solid object
![Page 31: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/31.jpg)
The Wrist & Hand- Fractures
Baseball (mallet) Finger Caused by an
object hitting the tip of the finger
Finger is bent beyond its normal range of motion
The finger tendon is torn and cartilage is damaged
![Page 32: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/32.jpg)
The Wrist & Hand- FracturesMallet Finger
FINGER TENDON IS TORN DUE TO OVER FLEXION
DAMAGE TO SURROUNDING TISSUE DUE TO OVER FLEXION AND FORCE OF IMPACT
![Page 33: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/33.jpg)
The Wrist & Hand- FracturesMallet Finger
Treatment RICE Support Evaluation by
physician
![Page 34: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/34.jpg)
The Wrist & Hand- Fractures
Jersey Finger Tearing of the
flexor tendon to the fingertip
Usually caused during a tackle
Most often affects the ring finger
![Page 35: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/35.jpg)
The Wrist & Hand- FracturesJersey Finger
INABILITY TO FLEX FINGER TREATMENT CONSISTS OF SURGERY TO REATTACH TENDON
![Page 36: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/36.jpg)
The Wrist & Hand- Fractures Scaphoid Fracture
Most commonly fractured bone in athletics
Caused by a fall on an outstretched hand
Palpation at the anatomical snuffbox will cause pain
![Page 37: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/37.jpg)
The Wrist & Hand- Fractures
Colles’s Fracture Common fracture
of the lower radius just above the wrist
![Page 38: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/38.jpg)
The Wrist & Hand- FracturesColles’s Fracture
CAUSED BY FALLING ON AN OUTSTRETCHED HAND AND THE WRIST
ABSORBS THE FORCE OF IMPACT
TREATMENT OFTEN REQUIRES SURGERY WITH HARDWARE
![Page 39: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/39.jpg)
The Wrist & Hand Carpal Tunnel
Syndrome Anatomy:
The carpal tunnel is a passageway that run from the forearm through the wrist
Bones form the walls and a ligament bridges over them
The median nerve and 9 tendons pass through the tunnel
![Page 40: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/40.jpg)
The Wrist & HandCarpal Tunnel Syndrome
Causes: Inflammation disorder
caused by: repetitive stress, physical injury, or other conditions that caused tissues to swell
Inflammation of the protective linings of the tendons
Thickening & broadening of the ligament that forms the roof of the tunnel
High force Repetition Awkward joint
posture Direct pressure Vibration Prolonged
constrained posture Dislocation Fractures Rheumatoid arthritis Diabetes Hypothyroidism
![Page 41: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/41.jpg)
The Wrist & HandCarpal Tunnel Syndrome
Signs & Symptoms Pain Numbness Tingling Weakness- drop things Loss of heat/cold
sensation Feeling of swollen
hands though there is no swelling
Symptoms may occur at rest as well as during use
![Page 42: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/42.jpg)
The Wrist & HandCarpal Tunnel Syndrome
Treatment Rest for at least 2 weeks Ice Splint or brace b
No real evidence they work Some believe they make the problem worse
Surgery
![Page 43: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/43.jpg)
The Wrist & Hand Ganglion Cyst
Small, hard lump above a tendon or in the capsule that encloses a joint
Also known as synovial hernia or synovial cyst
![Page 44: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/44.jpg)
The Wrist & HandGanglion Cyst
Common condition for: Bowlers Handball players Racquetball
players Squash players Tennis players
![Page 45: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/45.jpg)
The Wrist & HandGanglion Cyst
A ganglion can also appear: Palm side of the
wrist Base of the fingers Feet
Treatment Small cysts need
not be treated
![Page 46: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/46.jpg)
The Wrist & Hand Boutonnière
Deformity A tear or slip of the
extensor tendon of the proximal interphalangeal joint and the distal interphalangeal joint
![Page 47: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/47.jpg)
The Wrist & HandBoutonnière Deformity
Causes: Finger is bent or hit
forcibly Jammed finger
Signs & Symptoms Joints will be
painful and tender Unable to
straighten finger
![Page 48: Elbow, Wrist & Hand](https://reader035.vdocuments.site/reader035/viewer/2022081419/568166a9550346895dda9eb5/html5/thumbnails/48.jpg)
The Wrist & HandBoutonnière Deformity
Treatment Treatment must be
relatively quick to be effective
If not treated tissues will lose their elasticity- making it difficult for them to return to normal