Test 4- Ligament Injury

Question 1

Common ligamentous structures

Answer 1

• Lateral/collateral ligaments= prevents side to side movement
• Cruciate ligaments: prevent forward and backward movement
• Volar plates= prevent volar motion

Question 2

Collateral ligaments of the elbow

Answer 2

Ulnar collateral ligament is what gets stretched in pitchers (Tommy John’s)

Question 3

Ligament sprain

Answer 3

• Caused by overstretching and in some cases mild tears
• Requires 6-8 weeks of immobilization
• Anti-inflammatory medicines, ice, heat and ultrasound used for treatment
• If torn= pinning, screws or sutures, Allografts (from self or cadaver)

Question 4

Dislocation of joint

Answer 4

• Described by movement of the distal dislocating bone
• Glenohumeral jt most commonly dislocated (due to multiple directions of movement)
• fingers are second most common

Question 5

Dislocation recovery

Answer 5

• Injuries to the surrounding tissue usually take 6-12 weeks to heal
• injuries to Nn of vessels may result in more long-term issues
• Once a jt is dislocated it is more likely to happen again

Question 6

Radial head dislocation

Answer 6

Common in females and infants 2-5 yrs old

• radial head displaced with injury to annular ligament
• happens: after fall or child being swung by arms

Question 7

Radial dislocation interventions

Answer 7

• Sling: use following re-setting if site is tender
• Elbow sling: if treatment is delayed more than 12 hours
• Cast: if more than 3 recurrent episodes

Question 8

Treatment of ulnar dislocation

Answer 8

• Takes 2 people to preform reduction of joint
• Splinted or casted for 2-3 weeks (80-90 degrees flexion)
• Elbow is more stable in flexion than extension, so full extension not allowed until 4 weeks post injury

Question 9

Stability of UE joints

Answer 9

• Wrist: ligaments
• Shoulder: muscles
• Elbow: bones

Question 10

VISI

Answer 10

Volar intercalated segment instability

-Lunate stays with scaphoid in flexion secondary to a luno-triquetral ligament sprain/tear

Question 11

Jammed finger

Answer 11

• Usually the PIP is effected (difficult to get back to full motion)
• Collateral ligaments thicken
• If jam leads to dislocation- most common in PIP of digits 2-5 (80% of traumatic hand injuries)

Question 12

Finger dislocation splint

Answer 12

• If dislocation is distal, must allow active flexion but no active extension
• splint should be a dorsal blocking splint that blocks full extension to 30

Question 13

Buddy taped

Answer 13

After a joint reduction surgery, affected finger is taped to the closest finger for 3-6 weeks.

Question 14

Skier’s thumb

Answer 14

Torn ulnar collateral ligament

Question 15

DISI

Answer 15

Dorsal Intercalated Segment Instability

-scapho lunate tears result in dorsal instability because lunate stays with triquetrium