Trauma - Dislocations, Sprains and Strains, Other Injuries, Muscle Tears, Repetitive Strain Injury Flashcards
Dislocation?
separation of two bones as a joint with loss of contact between articulating bone surfaces
usually, one bone is out of position whereas the other remains in place
Subluxation?
bone is only partially displaced
partial loss of contact between surfaces
What is the main cause of Dislocation?
trauma e.g fall
some cases fractures are associated with dislocations
other cases underlying cause e.g. muscular disease
rheumatoid arthritis
or other damage such as torn ligaments may predispose individual to dislocation
Pathophysiology Dislocation:
considerable soft tissue damage
inc damage to ligaments, nerves, blood vessels
bone is pulled away from joint
Signs and Symptoms Dislocation:
Severe Pain Swelling Tenderness Bleeding Inflammation Deformity and limited movement evident
Dx Dislocation:
X-Ray confirmation
Tx Dislocation:
reduction to return the dislocated bone to normal position
immobilisation during healing
therapy maintain joint mobility
healing is slow if ligament and soft tissue extensively damaged
Sprain?
tear in a ligament
Strain?
tear in a tendon
Tendon
connect muscle to bone.
Ligament
connect one bone to another.
When can tendons or ligaments be torn easily?
when excessive force is exerted on a joint
Avulsion
ligament or tendon completely separated from their bony attachment
Signs and Symptoms Strains and Sprains:
painful tenderness marked swelling discolouration due to hematoma formation bleeding into joint capsule delays healing strength and range of movement limited
Dx Strains and Sprains:
X-ray and other tests to rule out fracture and determine the extent of damage
Pathophysiology Strains and Sprains:
after tear
- inflammation
- granulation tissue develops at the site
- collagen fibres are formed, creating links with remaining tendons or ligaments, eventually healing mass is bound
approx 6 weeks before tendon/ligament is strong again
What will early stress on a tendon cause during the healing process?
reopen tear, leading to the development of excessive fibrous in the tendon = - less strength - shortening = decreased flexibility at joint
What may be required to treat severe damage from strain and sprains?
Surgery
Predisposing factors for traumatic and overuse injuries:
- increased participation in fitness and recreational activities
- inappropriate or inadequate equipment/training/warm-up
- aggressive sports
- failure allow minor injuries to heal completely
- minor injuries - excessive use/abuse esp joints
- muscle tears more common
Muscle Tear?
tears along the muscle itself or at the points of attachment
Causes of muscle tears:
- direct trauma
- exertion/overstressing
First Degree (muscle tear) :
usually involves only a small percentage of muscle
the pain usually mild - does not result in an appreciable loss in strength of range of motion
Second Degree (muscle tear)
larger tear
involves much of the muscle but stops short of being a complete tear
the pain usually severe and muscle can be partially contracted with a substantial loss of strength and range of motion
Third Degree (muscle tear)
complete tear across the width of the muscle
muscle will be unable to contract
a great deal of internal bleeding
surgery may be required to repair tear for proper healing
Treatment - Tear:
as soon as tear occurs activity involving use muscle should stop
cold should be applied to help reduce internal bleeding
the compression bandage should be applied
lib affected area elevated
What will scar tissue cause following all types of muscle tears?
reduced flexibility
reduced strength
What can repeated injuries result in?
fibrous scar tissue replacing normal structures, hindering mobility, as well as permanent joint damage and development of osteoarthritis
What can repeated tears to the knee ligament cause?
repeated tears to knee ligament appear to cause early development of osteoarthritis
What can shoulder pain and damage to the rotator cuff from excessive swinging motions, esp w force (golf, tennis, hockey, painting walls/ceilings) lead to?
tendinitis
RSI
Repetitive Starin Injury
What does RSI refer to?
disorders affecting muscles, tendons and nerves that develop over a period of time
What does the cause of RSI appear to be?
repeated forceful or precision movements associated with work and sport-related activities
rapid repetition of certain movements interferes with circulation to the area and damages soft tissue with cumulative effects
most injuries affect the upper body
Who is at higher risk of RSI?
higher stress levels
age 30 to 50 years
work involving repetitive; lifting, pivoting, retrieving, shelving
Result of RSI?
pain
weakness
numbness
causing disability and interference with sleep
Examples of RSI:
tendinitis
inflammatory
injury of tendon and sheath
compression of peripheral nerve, seen in carpal tunnel syndrome
What happens in carpal tunnel syndrome?
the median nerve is compressed at the wrist between tendons and the transverse carpal ligament
What does a Dx of RSI require?
Hx
X-Rays
perhaps arthroscopic examination
Common Tx for RSI:
rest cold/heat application NSAIDs physiotherapy occupational therapy - ergonomic changes surgery
Common purposes of surgery in RSIs:
repair tears
remove damage
replace joints
What can Sports Medicine Clinics provide?
evaluation education preventative measure assitive devices rehabilitation programmes
