Glossary of Elbow Wrist and Hand Pathology

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movements of humeroradial & humeroulnar joints
flexion, extension
movements of radioulnar joint
pronation, supination
ligaments in the elbow
ulnar collateral, radial collateral, annular
functions of collateral ligments
add side to side stability
function of annular ligament
surround head of radius
action of muscles of anterior forearm
flexors, pronators
action of muscles of posterior forearm
extensors, supinators
Olecranon bursitis history
falling on the tip of elbow, very painful
Olecranon bursitis observations
visible deformity, contained swelling like a water balloon
Olecranon bursitis palpation
severe point tenderness, swelling can’t be “milked”
Olecranon bursitis treatment
RICE, may need to refer for aspiration
valgus force
from lateral side
varus force
from medial side
ulnar collateral ligament sprain history
valgus force, usually from repetitive motion; can be from hyperextension
radial collateral ligament sprain history
varus force; can be from hyperextension
medial epicondylitis
golfers elbow, racquetball elbow or pitchers elbow, tendonitis of flexors
medial epicondylitis history
repetitive forced flexion of the wrist
medial epicondylitis observation
weakness, swelling
medial epicondylitis palpation
point tenderness
lateral epicondylitis
tennis elbow, tendonitis of extensors
lateral epicondylitis history
repetitive wrist extension
lateral epicondylitis observation
weakness, swelling
lateral epicondylitis palpation
point tenderness
lateral epicondylitis treatment
RICE, strap for smaller injury, stretch, strengthen using eccentric contractions
elbow dislocation history
hyperextension from fall on extended arm, usually posterior movement of radius and ulna
elbow dislocation observation
visible deformity, if ischemic contracture is present, it’s a medical emergency
volkman’s ischemic contracture
flexors contract w/ damage to brachial artery, impinge or sever, can be irreversible
elbow dislocation palpation
can feel deformity, check for circulation distal to injury
elbow dislocation treatment
splint w/o compression, rapid transport to hospital for surgery; 1-2 hour window to avoid irreversible damage
ulnar nerve compression
injury to cubital tunnel
ulnar nerve compression history
repetitive valgus force, blunt trauma, c/o paresthesia in 4th, 5th & medial 3rd fingers
median nerve compression
injury to anterior side
median nerve compression history
repetitive flexion damages carpal tunnel, c/o paresthesia in thumb, 1st, 2nd, lateral 3rd
damage to soft tissue caused by compression between bone and a hard surface
forearm strain MOI
forceful contraction or overstretch
forearm strain healing time
4-6 weeks
forearm fracture s/s
swelling, maybe deformity, crepitus
forearm fracture healing time
6-8 weeks
lunate dislocation MOI
fall on hand
lunate dislocation s/s
not always visible, usu. palpable decr. ROM, pain
lunate dislocation
most common carpal dislocation
scaphoid fracture
most common carpal fracture
scaphoid fracture history
fall on outstretched hand w/ radial deviation
scaphoid fracture s/s
presents like sprain
scaphoid fracture palpation
severe point tenderness
scaphoid fracture treatment
cast over elbow to prevent pro/supination
scaphoid fracture danger
if not treated, can go arthritic b/c poor vascularity in the area can lead to non-union
silver fork deformity
radial fracture with posterior displacement @ wrist
carpal bones
4 proximal, 4 distal, 8 total
boutonniere deformity history
forceful flexion @PIP rupture central slip of ext tendon
boutonniere deformity observation
flex @PIP ext @DIP
jersey finger history
damage to flexors @ PIP & DIP , forced extension ruptures flexor tendons
jersey finger observation
extension @DIP, can’t flex, usually 4 phalanx
gamekeeper’s thumb
also skier’s thumb; sprain of ulnar collateral ligament @1st metacarpal-phalangeal joint
gamekeeper’s thumb MOI
forced abduction of thumb maybe w/ some hyperextension
gamekeeper’s thumb treatment
3rd degree needs surgery
scaphoid fracture complication
if not treated can go arthritic b/c poor vascularity can lead to non-union
finger sprain
damage to collateral ligaments
wrist ganglion
cyst; can be a herniation, removed only if it’s a problem
carpal tunnel syndrome
repetitive injury to flexors that run through carpal tunnel; tendonitis causes impingement of median nerve
carpal tunnel syndrome s/s
paresthesia in lateral hand c/o night pain
carpal tunnel syndrome treatment
sleep in splint to avoid all night flexion
boxer’s fracture
metacarpal fracture, compressive loading mode to longitudinal axis
mallet finger
trauma to finger tip, forced flexion so extensor tendon ruptures or avulses @ DIP; DIP stays flexed
finger dislocations
usually caused by severe sprain
finger fracture s/s
finger fracture palpation
crepitus, point tenderness
finger fracture observation
swelling, visible deformity
finger fracture treatment
splint, RICE, refer out
finger sprain treatment
ice in glass of ice water, buddy taping
subungual hematoma
bruise under finger or toe nail
subungual hematoma treatment
when new, burn hole in nail w/ hot paper clip; let blood out; will usually lose the nail
osteochondritis dissecans history
fracture through cartilage into bone leaving fragment in joint capsule
osteochondritis dissecans s/s
pain, feels like joint “locks up”, decreased ROM
osteochondritis dissecans treatment
detect on x-ray, surgery w/ scope

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