Elbow and wrist injuries Flashcards
Which 2 elbow ROM tests are most likely to be painful for an athlete who has recently dislocated their elbow?
Active and passive extension of elbow
Which resisted ROM table tests are most likely to be painful if you have acutely strained your distal biceps tendon? Which passive tests?
Resisted elbow flexion and forearm supination
Passive elbow extension and forearm pronation
Which two active and resisted ROM tests are most likely to be painful for an athlete with lateral epicondylalgia? Which passive test?
active and resisted wrist extension and radial deviation
Passive wrist flexion
Which two passive ROM tests are most likely to be painful for an individual with acute damage to the TFCC? Chronic TFCC?
Acute: passive wrist extension and ulnar deviation
Chronic: pronation and supination (connected to swinging sports)
Which special test is likely to be painful for both VEO syndrome and M-UCL sprain? Think of two ways these conditions differ from each other, in terms of clinical presentation
Valgus stress test for the elbow.
VEO develops over time (chronic) and MUCL sprain arises from an acute traumatic event.
MUCL can have bruising and swelling, not VEO.
VEO is associated with grating sensation, not MUCL
How do you perform the special test for TFCC? Focus on the athlete wrist position and motion, not your hand placements. What test in the lower extremity is this comparable to, and what do the two tests have in common?
Combine ulnar deviation with circumduction and compression (axial load). Just like McMurray’s for the knee, they both test a
structure made of fibrocartilage (TFCC vs. meniscus of knee).
Find three fracture tests you could perform to evaluate the scaphoid (exclude medical imaging such as x-ray). Aim to be able to describe how to perform them, and to perform them
yourself. Example: if you palpate something, where will you find it
Palpate the anatomic snuffbox (posterior aspect of base of thumb metacarpal), palpate the scaphoid tubercle on the palm of
the hand (distal to radius), scaphoid compression test (apply axial
load through the thumb, stabilize wrist).
The M-UCL (or UCL) can be surgically repaired
(replaced?) using a tendon of the forearm—which tendon, and what advantage is there to using this one over others?
The palmaris longus tendon; it has a similar size and strength, is relatively easy to harvest, and it has little functional impact once removed
Structures than can be damaged in elbow injury
-anterior and posterior band (ligament complex)
-joint capsule
-biceps
-tendons at medial epicondyle (wrist flexors)
-ulna nerve (felt in pinky finger)
-bone fractures (humerus, ulna, radius)
VEO clinical presentation
-medial and posterior aspect of elbow
-clicking or catching
-common in athletes who rapidly extend their elbow repeatedly (causes valgus)
VEO mechanics and tissue damage
-change at MUCL complex
-cartilage and bone, 2 sites: osteophytes (bony outgrowths around edge of joint surfaces), chrondromalicia (cartilage softens and weakens), osteochondritis dissecans (cartilage softens and weakens, followed by bone. Pieces break off an float in the joint)
Lateral epicodylagia MOI
-grip sports
-eccentric backhand stroke
-highly trained tennis athletes have less pain because they do not grip as hard/relax quickly after gripping tight
Impact-related wrist injury; primary location
Radius and scaphoid
