Trauma of Stress-Related Sprains

Question 1

What are some common musculoskeletal system trauma or stress-related sprains?

Answer 1

• strains
• back (disc, facet, malalignment)
• neck (whiplash, torticollis)
• TMJ
• foot disorders
• hand/finger disorders
• bursitis

Question 2

Signs and symptoms, differential diagnosis, and treatment of Colles’ fracture?

Answer 2

• most common wrist fracture, results from falling on an outstretched hand
  SS - distal radius has a dorsal (toward back of hand) shift and the hand/wrist shift towards the radially
  DD - radiographs show fracture and shift, observation or wrist radial shift/deformity.
  Tx - casting, early AROM and PROM are essential, closed chain stability exercises

Question 3

Signs and symptoms, differential diagnosis, and treatment of myositis ossificans?

Answer 3

• caused by trauma to a muscle causing a hematoma that calcify or ossify
• can be induced by early mobilization and stretching with aggressive PT following trauma to a muscle
  SS - common in quadriceps, brachialis, and biceps brachii muscles.
  DD - radiological studies will show calcium deposits
  Tx - gentle AROM and AAROM, passive stretching in NOT indicated, NO manual stretching w/overpressure at end-range.

Question 4

Signs and symptoms, differential diagnosis, and treatment of a scaphoid fracture (navicular)?

Answer 4

• results from fall on outstretched hand of younger person
• high risk of avascular necrosis of proximal fragment of scaphoid
  DD - radiological studies
  Tx - early maintenance of AROM of distal and proximal joints while casted, later emphasis on gaining full functional use of wrist/hand

Question 5

Signs and symptoms, differential diagnosis, and treatment of Smith’s fracture?

Answer 5

• distal fracture of radius, dislocates in the ventral directions (AKA reverse Colles’ fracture)
• results from falling on a flexed wrist
  Tx - casting of wrist joint, early AROM and PROM are essential for ultimate recovery, progressive resistance Ex, mobilizations, closed-chain stability Ex

Question 6

Signs and symptoms, differential diagnosis, and treatment of Tibial fracture?

Answer 6

Different types include
- March fracture of inferior third of tibia, common in persons who take long walks when they are not condition for it.
- Spiral fractures at junction of middle and inferior thirds, result in severe tibial torsion during skiing.
- Compound fractures from a direct blow to tibia (most common long bone to fracture and to compound fracture)
Tx - casting and possible hardware, may take up to 6 months to heal, after healing is complete AROM/PROM , progressive resistance Ex, mobilizations, and closed-chain stabilization