Elbow and Forearm Injuries Flashcards
the elbow is composed of \_\_ synovial joints surrounded by \_\_ capsule(s)
3; 1
What are the three synovial joints that surround the elbow?
radiohumeral, humeroulnar, radioulnar
Elbow - stability & power in ___ and hand positioning & function in ___
CKC; OKC
The elbow is second to ____ for dislocations associated with overuse injuries
shoulder
the humeroulnar is a ___ joint that performs?
hinge- flexion and extension
the humeroradial is a ___ joint that performs?
gliding - flexion and extension
the proximal radioulnar is a ___ joint that performs?
pivot - pronation and supination
The elbow has more ___ support and less ___ support then the shoulder.
boney; ligamentous
ligaments of the elbow? (5)
- ulnar (medial) collateral
- radial (lateral) collateral
- annular
- quadrate ligament
- oblique cord
bursae of the elbow?
olecranon
Neurovascular support is very close to the elbow joint, what does this mean with regard to injury?
injury can more easily cause impingement or cut off blood flow
“angle between humerus and ulna (arm in anatomical position)”
carrying angle
the carrying angle of the elbow is __-__ degrees
10-15
the carrying angle is greater in what gender?
females
chronic injuries to elbow? (2)
repetitive motions or incorrect mechanisms - eg. throwing
4 components of injury prevention about the elbow?
- protective equipment
- physical conditioning
- proper equipment
- proper skill technique
why do you have to make sure you treat the whole arm when working with an injured arm?
the elbow is in the middle of the arm so you must treat above and below
Olecranon bursitis is an ___ injury - what is it?
acute - big swelling right on the point of the elbow
Tennis elbow is a chronic elbow injury to the ____ epicondylitis
lateral
Golfer’s elbow is a chronic elbow injury to the ____ epicondylitis
medial
“inflammation of the common tendon”
epicondylitis
Etiology:
- Result of direct blow or repetitive blows
- May develop myositis ossificans
elbow contusions
Signs and Symptoms:
- Swelling (rapidly after irritation of bursa or synovial membrane); localized pain; bruising; ↓ROM.
- May have paraesthesia (numbness – usually down arm)
elbow contusions
management for elbow contusions?
RICE for at least 24 hours, and if severe, refer for x-ray
Etiology for Olecranon bursitis?
can be acute or chronic - caused via direct blow, repetitive pressure, and friction
Signs and symptoms of olecranon bursitis?
Pain, swelling, and point tenderness; limited ROM especially flexion
management for olecranon bursitis?
RICE, compression pad, NSAIDs, may need to be aspirated
Etiology:
Movement beyond normal ROM; sudden eccentric loading; repetitive microtears
elbow strain
Signs & Symptoms:
-Point tenderness in muscle or MTJ; swelling, bruising, possible deformity; pain with active & resisted motions
elbow strains
management for elbow strains?
RICE, sling in severe cases
Etiology:
-FOOSH (hyperextn); valgus or varus (driving out from the inside) force; repetitive forces
elbow sprain
Signs and Symptoms:
-Joint tenderness; painful ROM; laxity with stress tests; swelling; ↓ROM
elbow sprain
management for elbow sprain?
- RICE, tape, brace or sling; NSAIDs
- Surgery may be necessary (Tommy John surgery – have either avulsed the medial side or completely torn it
Etiology –
FOOSH forcing hyperextn; severe twist while flexed
Bones may be displaced A/P or laterally
elbow dislocation
Signs and Symptoms:
- Swelling, severe pain, disability, deformity; snapping or cracking sensation
- Possible neurovascular complications
- May involve radial head fracture
elbow dislocation
What direction of elbow dislocation is the most common?
posterior - if it is anterior then it usually means the elbow is broken
Management for elbow dislocation? (4)
- cold and pressure immediately
- transport to hospital for reduction
- monitor neurovascular function
- strengthening exercises for shoulder and hand
What is a possible complication with an elbow dislocation?
myositis ossificans
A FOOSH often fractures what part of the humerus? What type of deformity can this result in?
humerus above condyles or between condyles - may result in gunstock deformity
repetitive or sudden contraction of flexor-pronator group can cause what?
elbow avulsion fracture “little league elbow”
“a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers”
Volkmann’s contracture - elbow fracture
Etiology:
- Repetitive microtrauma to insertion of extensor muscles of lateral epicondyle; tendinosis without inflammation
- Incorrect racquet or grip size, or string tension too high; poor technique; eccentric loading of extensors during deceleration phase
lateral epicondylitis
Signs and Symptoms: -Aching pain in region of lateral epicondyle after activity -Pain worsens and weakness in wrist and hand develop -Elbow has decreased ROM; pain w/ resistive wrist extension
lateral epicondylitis
Management:
Management
-RICE, NSAID’s & rest
-ROM exercises, deep friction massage; mobilization and stretching in pain free ranges
-Use of a counter force or neoprene sleeve – trying to give the epicondyle a break
-Mechanics and skills training in order to avoid recurrence
lateral epicondylitis
Etiology:
- Repeated forceful flexion of wrist and extreme valgus torque of elbow
- May involve pronator teres, flexor carpi radialis and ulnaris, and palmaris longus tendons
- Can be associated with ulnar nerve neuropathy
medial epicondylitis
Signs & Symptoms:
- Pain produced with forceful flexion or extension
- Point tenderness and mild swelling
- Passive movement of wrist seldom elicits pain, but active movement does
medial epicondylitis
Management:
- Sling, rest, cryotherapy or heat through ultrasound
- Analgesic and NSAID’s
- Curvilinear brace below elbow to reduce elbow stressing
- Severe cases may require splinting and complete rest for 7-10 days
medial epicondylitis
In upper body rehab, restoration of proprioception and balance can be worked on through what type of exercises?
closed-chain
Muscular endurance, strength, and power work in upper body rehab can be worked on using what type of exercises?
PNF-resisted and open-chain exercises
In upper body rehab, what can be used to supply the load?
opposite hand
