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Title:

The Elbow, Forearm, Wrist, and Hand

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Phase I - immobilization (maintain wrist and hand strength) - 6 weeks ... Swan neck deformity. Etiology. Signs and Symptoms. Management. PIP Dorsal dislocation ... – PowerPoint PPT presentation

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Title: The Elbow, Forearm, Wrist, and Hand


1
The Elbow, Forearm, Wrist, and Hand
  • Chapter 19

2
Elbow Anatomy
  • Bones
  • Articulations
  • Ligaments and Capsule
  • Synovium and Bursa
  • Musculature
  • Nerve Supply
  • Blood Supply
  • Functional Anatomy

3
Preventing/Assessing Elbow Injuries
  • History
  • Observation
  • Palpation (bony and soft tissue)
  • Special Tests
  • Tinel sign
  • Test for capsular injury
  • Valgus and Varus tests
  • Medial and Lateral Epicondylitis Test
  • Pinch Grip test
  • Pinch Grip Test
  • Pronator Test syndrome test
  • Functional Evaluation

4
Recognition and Management of Injuries
  • Contusion
  • Etiology
  • Signs and Symptoms
  • Management
  • Olecranon Bursitis
  • Etiology
  • Signs and Symptoms
  • Management
  • Strains
  • Etiology
  • Signs and Symptoms
  • Management
  • Elbow Sprains
  • Etiology
  • Signs and Symptoms
  • Management
  • Lateral Epicondylitis
  • Etiology
  • Signs and Symptoms
  • Management
  • Medial Epicondylitis
  • Etiology
  • Signs and Symptoms
  • Management

5
Recognition and Management of Injuries (contd.)
  • Elbow Osteochondritis Dissecans
  • Etiology
  • Signs and Symptoms
  • Management
  • Little League Elbow
  • Etiology
  • Signs and Symptoms
  • Management
  • Cubital Tunnel Syndrome
  • Etiology
  • Signs and Symptoms
  • Management
  • Elbow Dislocation
  • Etiology
  • Signs and Symptoms
  • Management
  • Fracture of the Elbow
  • Etiology
  • Signs and Symptoms
  • Management
  • Volkmanns Contracture
  • Etiology
  • Signs and Symptoms
  • Management

6
Rehabilitation Principles for the Elbow
  • Phase I - immobilization (maintain wrist and
    hand strength) - 6 weeks
  • Phase II - Increase ROM (after cast removal)
  • Therapy Ice (5 to 15 minutes)
  • Exercise PREs in all directions
  • General Body Conditioning
  • Joint mobilization
  • Flexibility
  • Strengthening
  • Functional Progression
  • Return to Activity
  • Protective Taping and Bracing

7
Forearm Anatomy
  • Radius and Ulna Elbow
  • Joints radioulnar joint (superior, middle,
    and distal)
  • Bone proximal radial head, olecranon process,
    radial shaft, ulnar shaft, distal radius, radial
    styloid process, ulnar head, ulnar styloid
  • Musculature Forearm, flexors, pronators,
    extensors, and supinators
  • Nerve/Blood Supply median and radial nerve and
    brachial, radial, and ulnar artery

8
Forearm Assessment
  • History
  • Observation
  • Palpation
  • Special Tests

9
Recognition and Management of Forearm Injuries
  • Contusion
  • Etiology
  • Signs and Symptoms
  • Management
  • Forearm Splints
  • Etiology
  • Signs and Symptoms
  • Management
  • Colles fracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Forearm Splints
  • Etiology
  • Signs and Symptoms
  • Management

10
Wrist, Hand, and Finger Anatomy
  • Bones carpals and metacarpals
  • Joints radiocarpal, carpal, metacarpal, and
    phalangeal joints
  • Ligaments many at each joint in the hand
  • Musculature many intrinsic and extrinsic
    muscles
  • Blood and Nerve Supply ulnar, median, radial
    nerve and radial and ulnar superficial and deep
    palmar arch arteries

11
Assessment of Wrist, Hand, and Finger Injuries
  • History
  • Observation
  • Palpation
  • Special Tests Finklesteins test, Tinels Sign,
    Phalens test, valgus and varus stress test,
    Glide test, Lunotriquetral Ballotment test
  • Circulatory and Neurological Evaluation
  • Allen test
  • Functional Evaluation

12
Recognition and Management of Wrist, Hand, and
Finger Injuries
  • Wrist Sprain
  • Etiology
  • Signs and Symptoms
  • Management
  • Triangular Fibrocartilage Complex Injury
  • Etiology
  • Signs and Symptoms
  • Management
  • Carpal tunnel syndrome
  • Etiology
  • Signs and Symptoms
  • Management
  • Tenosynovitis
  • Etiology
  • Signs and Symptoms
  • Management
  • Tendinitis
  • Etiology
  • Signs and Symptoms
  • Management
  • Nerve Compression, Entrapment, Palsy
  • Etiology
  • Signs and Symptoms
  • Management

13
Recognition and Management of Wrist, Hand, and
Finger Injuries
  • De Quervains Disease
  • Etiology
  • Signs and Symptoms
  • Management
  • Dislocation of the Lunate Bone
  • Etiology
  • Signs and Symptoms
  • Management
  • Scaphoid Fracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Hamate Fracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Wrist Ganglion
  • Etiology
  • Signs and Symptoms
  • Management

14
Recognition and Management of Wrist, Hand, and
Finger Injuries
  • Contusion to hand and fingers
  • Etiology
  • Signs and Symptoms
  • Management
  • Bowlers Thumb
  • Etiology
  • Signs and Symptoms
  • Management
  • Jersey finger
  • Etiology
  • Signs and Symptoms
  • Management
  • Trigger finger or thumb
  • Etiology
  • Signs and Symptoms
  • Management
  • Mallet finger
  • Etiology
  • Signs and Symptoms
  • Management
  • Boutonniere deformity
  • Etiology
  • Signs and Symptoms
  • Management

15
Recognition and Management of Wrist, Hand, and
Finger Injuries
  • Dupuytrens Contracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Sprains, Dislocations, and Fractures
  • Etiology
  • Signs and Symptoms
  • Management
  • Gamekeepers Thumb
  • Etiology
  • Signs and Symptoms
  • Management
  • Sprains PIP and DIP joint
  • Etiology
  • Signs and Symptoms
  • Management
  • Swan neck deformity
  • Etiology
  • Signs and Symptoms
  • Management
  • PIP Dorsal dislocation
  • Etiology
  • Signs and Symptoms
  • Management

16
Recognition and Management of Wrist, Hand, and
Finger Injuries
  • MCP dislocation
  • Etiology
  • Signs and Symptoms
  • Management
  • Metacarpal fracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Bennetts Fracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Distal/Middle/Proximal phalangeal fracture
  • Etiology
  • Signs and Symptoms
  • Management
  • Fingernail deformity
  • Etiology
  • Signs and Symptoms
  • Management

17
Rehabilitation Principles for the Forearm, Wrist,
Hand, and Fingers
  • General Body Conditioning
  • Joint Mobilization
  • Flexibility
  • Strength
  • Neuromuscular Control
  • Return to Activity
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