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Elbow and Forearm Injuries

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Elbow and Forearm Injuries Taelar Shelton, MS, ATC, AT/L Contusions Soft tissue or bone contustions Usually on the medial aspect MOI- collision, repeated blows Acute ... – PowerPoint PPT presentation

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Title: Elbow and Forearm Injuries


1
Elbow and Forearm Injuries
  • Taelar Shelton, MS, ATC, LAT, CES

2
Contusions
  • Soft tissue or bone contustions
  • Usually on the medial aspect
  • MOI- collision, repeated blows
  • Acute contusions- pain, swelling, hematoma
  • Chornic- scars and bony callus
  • Treatment- RICE, protection, may need x-ray if
    serious

3
Olecranon Bursitis
  • Most common bursitis in the elbow
  • Superficial location
  • Acute or chronic- direct blow MOI
  • SS- pain, warm, point tender, swelling
  • Try conservative Rx first- cold compression
  • Aspiration if serious

4
Strains
  • Muscles around elbow
  • Excessive restrictive ROM
  • Usually from a fall or repeated microtraumas
  • X-ray to r/o avulsion or epiphyseal Fx
  • RICE, rehabilitation exercises, theraputic
    ultrasound, cryotherapy (ice)

5
Sprains
  • Ligaments around the elbow
  • Usually from hyperextension of elbow joint
  • SS- pain, shifting of elbow joint,
    click/pop/snap, crepitis, tender to palpation,
    swelling, decrease in function of elbow
  • Cold compress, main concern is ROM, do not
    massage, taping may assist in protecting injury

6
Lateral Epicondylitis
  • Tennis Elbow is inflammation of extension
    muscles at the lateral epicondyle
  • Repetitive extension of the wrist, throwing,
    microtrauma
  • SS- pain during flexion/extension exercises,
    pain may radiate down the arm, mild swelling,
    point tenderness
  • RICE for actue tendonitis, chronic- bracing or
    taping and rehab

7
Medial Epicondylitis
  • Golfers Elbow is inflammation of the flexor
    tendons at the medial epicondyle
  • Repetitive flexion of the wrist, pitching, golf
    swing
  • Same Rx as tennis elbow

8
Osteochondritis Dissecans
  • OCD also occurs in the knee
  • Occurs in the bone and articular cartilage
  • Impariment of blood supply, causes loose bodies
    in the joint
  • Locking joint
  • Can require surgery
  • Can lead to arthritis

9
Ulnar Nerve Injuries
  • Ulnar nerve is involved
  • MOI- friction due to valgus force at elbow
  • Can be caused by impingment at the elbow
  • SSS- parasthesia down ulnar side of forearm,
    numbness and tingling
  • Rx- Avoid pressure, can require surgery

10
Dislocation of the Elbow
  • FOOSH is a common MOI
  • Can dislocate anteriorly, posteriorlly or
    laterally
  • Olecranon deformity
  • Many ligmaents and tendons can be involved and
    may also cause a Fx
  • Referral imediately, reduction by MD, sling,
    immobilize in flexion, rehab

11
Volkmans Contracture
  • Complication of a serious injury
  • Causes blood flow problems
  • SS pain, swelling, muscle spasm, pressure
  • Leads to permanaent muscle contracture and
    permanent paralysis in servere cases
  • Immediate referral

12
Fractures- Elbow
  • Humerus, radius or ulna
  • Usually a FOOSH or direct blow MOI
  • Higher rate of injury in children
  • SS discoloration, swelling, muscle spasm, bone
    displacement is possible, swelling and muscle
    spasm
  • Referral for X-ray

13
Wrist/Hand Injuries
14
Contusion
  • Ulnar side of forearm and wrist at risk
  • Can be acute or chronic
  • Pain, swelling, hematoma
  • Chronic injury can result in scar tissue
  • Treatment- RICE, protection through padding

15
Strains
  • Usually from repeated contractions
  • Chronic fatigue, irritation in deep forarm
    muscles and tissue
  • Rx- strengthening though reisistance exercises,
    rest, heat and ice, supportive wrap

16
Fractures
  • Common in youths and children
  • FOOSH
  • Pain, swelling, deformity and a false joint
  • Possibility to develop Volkmanns contratures
  • Rx- splint and refer to physician

17
Colles Fx
  • Fracture to the distal radius
  • FOOSH, hyperextension
  • Visible deformity
  • Ligaments are usually involved
  • Splint and get an xray

18
Carpal Tunnel Syndrome
  • Anterior aspect of the wrist
  • Transverse ligament can be too tight
  • Usually overuse but can be from a direct blow
  • Limited space for structures
  • SS complain of numbnress and tingling

19
de Quervains Tendosynovitis
  • Synovial lining becomes inflammed
  • Constant wrist movement makes this worse
  • SS aching, radiating pain in the forearm, pain
    with extension of the thumb, may hear a snap with
    movement
  • Rx imobilize, ice, rest, antiinflammatory
    medications

20
Scaphoid Fx
  • Most common carpal bone fracture
  • FOOSH
  • Can be misdiagnosed as a sprain
  • Poor blood supply to this bone- can lead to
    necrosis
  • Need to get an xray and imoblize

21
Hamate Fx
  • MOI from the handle of a golf club, tennis
    racquet or baseball bat
  • SS wrist pain, weakness
  • Usually needs to be casted

22
Wrist Ganglion
  • Herniation of the joint capsule or synovial
    sheath of a tendon
  • Can aslo be a cyst
  • Occurs after a wrist sprain that did not get
    proper Rx
  • Rx Apply a pressure pad, surgical removal or
    draw the fluid out

23
Lunate Dx
  • Most common bone to dislocate of the carpal bones
  • Usually dislocates anteriorly
  • Deformity on the palmar aspect
  • Murphys sign
  • Reduction by a physician
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