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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. Olecranon Bursitis. Most bursitis in the elbow Superficial location Acute or chronic Try conservative Rx first Aspiration. Lateral Epicondylitis.
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Elbow andForearm Injuries Taelar Shelton, MS, ATC, AT/L
Contusions • Soft tissue or bone contustions • Usually on the medial aspect
Olecranon Bursitis • Most bursitis in the elbow • Superficial location • Acute or chronic • Try conservative Rx first • Aspiration
Lateral Epicondylitis • “Tennis Elbow” • Repetitive extension of the wrist • RICE for actue tendonitis
Medial Epicondylitis • “Golfer’s Elbow” • Repetitive flexion of the wrist • Same Rx
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
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
Fractures- Elbow • Usually a FOOSH or direct blow MOI • Higher rate of injury in children • S&S: discoloration, swelling, muscle spasm • Referral for X-ray
Volkman’s Contracture Complication of a serious injury Causes blood flow problems S&S: pain, swelling, muscle spasm, pressure Leads to permanaent muscle contracture and permanent paralysis in servere cases Immediate referral
Colles’ Fx • Fracture to the distal radius • FOOSH, hyperextension • Visible deformity • Ligaments are usually involved • Splint and get an xray
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 • S&S: complain of numbnress and tingling
de Quervain’s Tendosynovitis • Synovial lining becomes inflammed • Constant wrist movement makes this worse • S&S: aching, radiating pain in the forearm, pain with extension of the thumb, may hear a snap with movement • Rx: imobilize, ice, rest, antiinflammatory medications
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
Hamate Fx • MOI: from the handle of a golf club, tennis racquet or baseball bat • S&S: wrist pain, weakness • Usually needs to be casted
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
Lunate Dx • Most common bone to dislocate of the carpal bones • Usually dislocates anteriorly • Deformity on the palmar aspect • Murphy’s sign • Reduction by a physician