lecture 11- upper extremity injuries Flashcards
elbow area contusions
laterally= radial nerve at risk
extensor muscle weakness
posterolateral numbness
medially= ulnar nerve at risk
“funny bone” injuries
numbness in medial forearm and digits IV +V
flexor muscle weakness
posteriorly:
olecranon bursitis
Strains and tendinopathy
Hx: resisting a force, fall, overuse
SSx: pain worse with movement against resistance, tenderness, swelling, crepitus
–> using equipment that is too big? Often happens with kids
Tx: rest, POLICE, ROM, physio, tape, shin splints, rehab
most dislocated carpal bone
lunate
most fractured carpal bone
scaphoid
2 nail injuries
- Avulsion (nail ripped off, high chance of infection)
- Subungual haematoma (contusion, crush, bleeding under nail)
Superficial hand injuries:
Hand abrasions, lacerations
- always looking for infections with these!!!!!
Laceration= a cut (ex. tip of finger cut off)
biceps tendinopathy
tendinosis in biceeps, male athletes 45-60 years old
SSx: pain anterior shoulder, pain w 900 to 120 degrees shoulder flexion
Tx: rest, ice, modified activities, ROM, strengthening
can lead to biceps rupture
biceps rupture
SSx: snap, weakness, bruising, popeye’s sign (sticking up lump in biceps)
MRI or diagnostic ultrasound
Tx: surgery, rehab
Medial/lateral epicondylalgia
golfers/tennis elbow
SSx: aching pain, worse w movement
TX: rest, splints, ice, physio (eccentric loading), NSAIDs, rehab, surgery
tendinopathy in forearm and wrist areas may result in
may result in ganglion
–> cyst in tenosynovium or swelling in joint capsule
-mobile, swollen, painful, crepitus
-may lead to carpal tunnel syndrome if on palmar side (by putting pressure on the carpal tunnel)
Tx: surgery
carpal tunnel syndrome
swelling in tunnel causes compression of median nerve
Hx: repeated wrist flexion (tendinopathy), trauma (sprain, fracture, dislocation), ganglion, tumour, pregnancy
SSx:
pain, worse at night and at rest
numbness/weakness of thumb
atrophy of thenar eminence
carpal tunnel brace?
only at nigh bc it actually increases muscle activity and causes more harm than good w active movement bc have to overcome resistance!!
carpal tunnel syndrome Tx
POLIE, tear underlying cause
splint
send to MD
NSAIDs
may need surgical decompression
De quervain’s tenosynovitis
Hx
cause: repetitive use of wrist/thumb, w wrist in ulnar deviation
—> inflammation of abductor pollicis longus and extensor pollicis brevis tendon sheaths
(much more common w phone!!! having to reach w thumb)
De quervain’s tenosynovitis
SSx, Tx
SSx: pain/swelling at base of thumb/radial side of wrist.
pain and stiffness w radial deviation of wrist and thumb flexion
Tx: POLIE, rest, brace, physio, corticosteroid injection, surgery
