Wrist and Hand Flashcards
MOI of forearm fracture:
falls (FOOSH) and direct blows
Signs and symptoms of forearm fracture:
-audible pop crack followed by moderate to severe pain, swelling and disability.
-edema and ecchymosis with possible crepitus
3 forearm fracture management:
1.POLICE (followed by splinting)
2. Check PMS
3. Long-term splinting followed by rehabilitation plan
Where does Colle’s fracture occur?
lower end of radius or ulna
Whats the MOI of Colle’s fracture?
-FOOSH forcing distal radius and ulna into posterior displacement
whats the less common/reverse of colle’s fracture?
Smith fracture (anterior displacement of distal fragment)
Colle’s fracture sign and symptoms? 3 things
- Visible deformity (dinner fork)
2.Misdiagnosed with bad sprain (when no deformity present)
3.may include median nerve damage
Colles fracture managment:
-acute management splint, refer to physisan
-xray and immobilization
what should severe sprain be treated as?
fractures
In children colles fracture may cause
lower epiphyseal seperation
What’s different for observations for wrist and hand?
thumb to finger touching
color of nail beds/cap refill
Wrist sprains MOI
-any forced movement
(often unexpected or uncontrollable)
signs and symptoms of wrist sprain:
pain,swelling and difficulty with movement
Management of wrist sprain: 4 things
- refer to physisan for xray (if severe)
2.POLICE, splint
3.Active rehad as soon as symptoms allow - Tape for support to prevent further injury
MOI of Triangular fibrocartilage complex (TFCC):
twist or torque of wrist
addition of _______ may increase severity inTriangular fibrocartilage complex (TFCC):
Ulnar deviation
what is Triangular fibrocartilage complex often associated with?
Sprain of UCL
Signs and symptoms of Triangular fibrocartilage complex: 2 things
- pain along ulnar side of wrist, clicking, pain with ulnar deviation
-patient may not report injury immediately (symptoms may increase gradually)
Management of Triangular fibrocartilage complex (TFCC):
-refer to physican for initial management
-conservative treatment initially
—–> immobilize for 4 weeks
surgical intervention may be needed for TFCC if
conservative treatments fail
is tape effective in managing symptoms for TFCC?
yes very effective
deQuervains syndrome what is it?
tendinopathy in thumb (extensor pollicis brevis and abductor pollicis longus)
MOI of deQuervains syndrome
-constant wrist movement
-common in those training with a barbell frequently
Signs and symptoms of deQuervains syndrome:
-aching pain that may radiate into hand and forearm
-point tenderness and weakness during thumb extension ab duction (loaded eccentric strain)
positive _____ test for deQuervains syndrome
Finkelstein’s
Finkelstein’s test:
-athlete makes a fist with thumb tucked inside
-wrist ulnarly deviated
-positive pain along EPB/APL
Management of deQuervains syndrome:
immobilization,rest,cryotherapy
manual therapy at the site of pain to reduce ________ for deQuervains syndrome
excessive fibrosis
Dislocation/sublaxation of lunate bone MOI:
-forceful hyperextension or fall on outstretched hand
signs and symptoms of Dislocation/sublaxation of lunate bone: 3 things
- pain
- swelling
- difficulty executing wrist flexion
management of Dislocation/sublaxation of lunate bone:
-refer to physician
-can lead to hypermobile lunate or unstable scapho lunate complex
MOI of scaphoid fracture:
-force on outstretched hand
-compressing scaphoid between radius and second row of carpal bones
scaphoid fractures often fail to _______ due to _______ :
heal due to poor blood supply
signs and symptoms of scaphoid fracture:
-swelling and severe pain in anatomical snuff box
-pain with radial flexion
what do scaphoid fracture present as?
wrist sprain
management of scaphoid fracture:
-must be splinted and referred for X ray
immobilization of scaphoid fracture lasts:
6 weeks
wrist requires protection against _______ for ________ months (scaphoid fracture)
against impact loading for additional 3 months
Unstable fractures extending through the scaphoid will need
surgical stabilization
scaphoid fracture may become
non-union fracture, extending the time for healing = risk for avascular necrosis
extensor tendon alvusion (mallet finger) MOI:
-blow to tip of finger avulsing extensor tendon from insertion
signs and symptoms of extensor tendon alvusion (mallet finger):
-Pain at DIP joint
-unable to extend distal end of finger
(carrying at 30 degree angle)
-point tenderness
management of extensor tendon alvusion (mallet finger):
POLICE and splinting for 6-8 weeks
flexor digitorum profundus rupture (jersey finger) is the rupture of
flexor digitorum profundus tendon from insertion on distal phalanx
flexor digitorum profundus rupture (jersey finger) MOI:
occurs ring finger when athlete tries to grab a jersey
signs and symptoms flexor digitorum profundus rupture (jersey finger):
-distal phalanx cannot be flexed…. finger remains extended
-pain and point tenderness over distal phalanx
managment of flexor digitorum profundus rupture (jersey finger):
-must be surgically repaired
-extensive rehab
does a flexor digitorum profundus rupture (jersey finger) often return to full function?
NO
gamekeepers thumb is a sprain of the
sprain of UCL and MCP joint of thumb
MOI of gamekeepers thumb
forceful ab duction of proximal phalanx, occasionally combined with hyper extension
signs and symptoms of gamekeepers thumb:
pain over UCL in addition to weak and painful pinch
management of gamekeepers thumb: if UNSTABLE
athlete should be referred to orthopedist
management of gamekeepers thumb: if STABLE
x-ray should be performed to rule out fracture
thumb splint should be applied for protection for
three weeks or until pain free
the splint should extend from ________ to _________ in a _________ position
wrist, end of thumb, in a neutral position
thumb spica should be used
following a splint for support
Dislocation of phalange MOI
hyperextension or twisting in semi flexed
signs and symptoms of phalange dislocation:
- pain and swelling over PIP
-obvious deformity,disability, and possible avulsion
finger dislocation management: (if angulated or unstable)
-splint on field and transport secure
how long does it take to recover finger dislocation?
-6 to 8 weeks
