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What am I?

What am I?. Articulations of the humerus , radius, and ulna. [ olecranon process ] Medial collateral ligament: 3 portions, anterior, posterior, oblique.

blaine-maxwell
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What am I?

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  1. What am I?

  2. Articulations of the humerus, radius, and ulna. [ olecranon process ]Medial collateral ligament: 3 portions, anterior, posterior, oblique The anterior fibers are tight in extension, while the posterior fibers are tight in flexion [ beyond 90 degrees ] The posterior fibers are fan shaped and thin when compared to the anterior fibers.

  3. Causes: Back Hand Swing (tennis); Painting ; Carrying heavy buckets

  4. Lateral Epicondylitis Symptoms: Point tenderness @ lateral epicondyle; radiating pain to mid forearm and into the middle and ring finger; stiffness in elbow.

  5. Medial Epicondylitis – Golfer’s Elbow

  6. Movements of elbow Elbow: flexion - extension Wrist: supination - pronation - ulnar and radial deviation flexion and extension Flexion and extension originate at the humeroradial and humeroulnar joints while pronation and supination occur from the radio scaphoid (Navicular) articulations at the wrist and the radioulnar joint at the elbow.

  7. Elbow Dislocations 6. Dislocations (fractures of the coronoid process occur in approx. 35-40% of elbow dislocations) Dislocations of the elbow are infrequent occurrences in intercollegiate athletics. However, when they do occur, the are often serious injuries due to the potential for fractures and impaired distal circulation.

  8. Muscles of elbow, wrist, & hand • Biceps = primary supinator of the forearm also primary for elbow flexion. • Brachial, originates on the humerus, extends anteriorly across the joint and inserts into the ulna. • Triceps, 3 heads, Primary responsible for extension of elbow. • Flexor - pronator group, originates on medial side • Extensor - supinator group, • Olecranonbursae, separates the skin over the tip of the elbow from the pointed end of the ulna. [ Olecranon process ] • Radial - humeral bursae, lies anteriorly between the radial head and the lateral epicondyle between the muscle attachments

  9. Hand & Wrist Injuries • Gamekeeper’s Thumb • Mallet Finger • Jersey Finger • Central Slip Injury / Boutenniere Deformity • Swan Neck Deformity • Colles Fracture / Smith Fracture • Scaphoid Fracture • Bennet’s Fracture • Boxer’s Fracture • Dislocated Fingers • Smash/Avulsion Injuries

  10. Gamekeeper’s Thumb Normal thumb Normal Carrying Angle Gamekeeper’s Sprain (Notice the opening of joint

  11. Mallet Finger • How ? • Hit on tip of finger with ball • S/S? • Tip of Finger Drops • Blood under nail • Swelling • Tx? • PRICE, Splint into ext., Need to refer within a week

  12. Mallet Finger

  13. Jersey Finger • How? – Flexor tendon rupture • Finger caught in jersey • S/S? • Unable to actively flex finger at DIP or PIP joint • DIP represents Profundus rupture • PIP represents Superficialis rupture • TX? • Surgery • Splint

  14. Jersey Finger

  15. Swan Neck Deformity

  16. Swan Neck Deformity DIP goes into extension PIP goes into flexion

  17. Central Slip Injury / Boutenniere Deformity • How? • PIP forceabley flexed and extended @ same time • Common in Basketball Players • S/S? • Unable to actively extend the joint • Tenderness over the dorsal aspect of the middle phalanx • Tx? • Splint in full extension x 6 weeks

  18. Central Slip Injury / Boutenniere Deformity

  19. Colles Fracture • What? • Distal Radial Fracture • Most common arm fracture • How? • Fall on outstretched hand • Wrist goes into extension • S/S? • immediate (acute) pain, • tenderness, bruising, and swelling • Frequently, the wrist hangs in an odd or bent way (deformity). • TX? • PRICE • Refer to MD • Cast if no surgery • Surgery possible

  20. Colles Fracture

  21. Smith Fracture • What? • Distal Radial Fracture • How? • Fall on flexed hand • S/S? • Same as Colles Fracture • TX? • Same as Colles Fracture

  22. Scaphoid Fracture • What? • Fracture small carpal bone • 2nd most common wrist fracture • How? • Fall on outstretched hand • S/S? • Swelling • Point tenderness (anatomical snuff box) • TX? • Refer for xray – CYA!!!

  23. Bennett’s Fracture • Fracture of 1st MCP jt • Fall on outstretched hand • Dropped object • TX • Refer for xray • Splint

  24. Boxer’s Fracture • Break in the small end of the 5th metacarpal • What caused it? Punching something harder than the hand, such as a wall or another person's head. • TX? • PRICE REFER

  25. Dislocated Fingers • During sports activities, a basketball or baseball may strike the tip of an outstretched finger. • Your finger might get caught in equipment such as a game jersey or pads. • You might fall onto your outstretched hand.

  26. Dislocated Finger • Do Not Try to Reduce! • Splint • Refer • S/S • Obvious Deformity • Pain • Swelling

  27. Smash / Avulsion Injury

  28. Smash / Avulsion Injury 3 months post op

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