Elbow, Forearm, Wrist - PowerPoint PPT Presentation

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Elbow, Forearm, Wrist

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Elbow, Forearm, Wrist & Hand Just Because It Looks Cool Open Dislocation of Thumb Def: Dislocation of thumb which breaks the skin. MOI: Direct blow to the thumb. – PowerPoint PPT presentation

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Title: Elbow, Forearm, Wrist


1
Elbow, Forearm, Wrist Hand
2
Dislocated Elbow
  • Def Dislocation of the radius and/or ulna.
    Usually it is a posterior dislocation of both
    bones.
  • MOI A fall on the outstretched arm with the
    elbow hyperextended or a severe twist with the
    elbow flexed.

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  • S/Sx Severe pain and disability. Obvious
    deformity. Profuse hemorrhage and swelling.
    Complications include injury to the median and
    radial nerves and to the major blood vessels and
    arteries.
  • Tx Apply cold and pressure immediately, then a
    sling and refer to a doctor. Reducing an elbow
    dislocation should never be attempted by anyone
    other than a physician.

7
Olecranon Bursitis
  • Def inflammation of the olecranon bursae
    of the elbow
  • MOI fall on or blow to the tip of the
    elbow
  • S/Sx obvious localized swelling
  • Tx ice, rest, NSAIDs and protective padding

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Epicondylitis
  • Medial epicondylitis
  • Def inflammation of the origins of the flexors
    at the medial epicondyle
  • MOI repetitive forceful flexion of the wrist
  • Also known as pitchers elbow or little league
    elbow

10
  • Lateral epicondylitis
  • Def inflammation of the origin of the extensors
    at the lateral epicondyle
  • MOI repetitive forceful extension of the wrist
  • Also known as tennis elbow

11
  • S/Sx pain over the attachment point and pain
    with either wrist flexion (medial epicondylitis)
    or wrist extension (lateral epicondylitis)
  • Tx rest, NSAIDS, ultrasound
  • Brace or tape below the elbow joint
  • stretch

12
Colles Fracture
  • Def A fracture to the distal end of the ulna
    and/or radius.
  • MOI A fall on the outstretched hand, forcing
    the radius and ulna backward and upward

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  • S/Sx In most cases there is forward
    displacement of the radius that causes deformity
    of the wrist. Positive percussion and
    compression test.
  • Tx Apply ice, splint the wrist and refer to a
    doctor. Athlete will be out 1-2 months.

15
Mallet Finger
  • Def An avulsion of the extensor tendon usually
    along with a piece of bone.
  • MOI Common in sports, particularly baseball and
    basketball. Caused by a blow to the tip of the
    finger.

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  • S/Sx Inability to extend the tip of the finger
    DIP joint (distal interphalangeal joint)
  • Tx Ice, x-ray and splint the joint in extension

18
Boutonniere Deformity
  • Def A rupture of the extensor tendon of the
    middle phalanx.
  • MOI A blow to the tip of the finger.

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  • S/Sx The athlete complains of severe pain and
    the inability to extend the PIP (middle) joint.
    The PIP joint is fixed in flexion and the DIP
    (end) joint is fixed in extension.
  • Tx Apply ice and splint finger with the middle
    joint in extension. Refer to a doctor.

21
Jersey Finger
  • Def Rupture of flexor digitorum profundus tendon
    off distal phalanx
  • MOI most often occurs in the ring finger when
    the athlete tries to grab the jersy of an
    opponent

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  • S/Sx DIP joint is fixed in extension, inability
    to actively flex DIP joint, can passively flex
    it, pain and point tenderness over distal
    phalanx.
  • Tx Tendon needs to be surgically repaired or
    athlete will never be able to flex DIP joint.
    Rehab lasts approximately 12 weeks.

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Gamekeepers Thumb
  • Def A sprain of the ulnar collateral ligament
    of the MCP joint of the thumb.
  • MOI A forceful abduction of the thumb,
    occasionally combined with hyperextension of the
    thumb.

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  • S/Sx Point tenderness over the ulnar aspect of
    the MCP joint. Pain with or inability to grip.
    Positive valgus stress test.
  • Tx RICE, NSAIDs, splint the thumb close to the
    hand. In cases of severe disability refer to a
    doctor.

27
Dislocated Finger
  • Def A dislocation of any joint in the finger.
    Usually, the first of second joint is displaced
    dorsally.
  • MOI A blow to the finger, usually directed from
    the palmar side upward.

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  • S/Sx Obvious deformity. Inability to move
    injured joint.
  • Tx Dislocations may be reduced without doctor
    referral. After reduction, ice and a splint
    should be applied. If a fracture or tendon
    rupture is suspected refer to a doctor.
  • Note never reduce a dislocated thumb!

30
Navicular fracture
  • Def fracture of the navicular/scaphoid bone.
    Most commonly fractured carpal bone
  • MOI fall on an outstretched hand

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  • S/Sx often appears to be a wrist sprain.
    Increased pain with palpation in the anatomical
    snuff box. Swelling in anatomical snuff box. Pain
    when pressure is applied to long axis of thumb
  • Tx ice, immobilize, refer to doctor. Cast for
    about 4 months

33
  • Complications
  • The scapoid has a poor blood supply
  • If not immobilized properly part of the bone will
    not heal
  • That part of the bone will die due to avascular
    necrosis
  • May result in arthritis

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Just Because It Looks Cool
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Open Dislocation of Thumb
  • Def Dislocation of thumb which breaks the skin.
  • MOI Direct blow to the thumb.
  • S/Sx Pretty obvious
  • Tx Reduce the dislocation using sterile gloves.
    Place sterile gauze over injury and send
    immediately to a doctor.
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