Download Elbow and Forearm Injuries

Elbow and
Forearm Injuries
Taelar Shelton, MS, ATC, LAT, CES
Contusions

Soft tissue or bone contustions

Usually on the medial aspect

MOI- collision, repeated
blows

Acute contusions- pain,
swelling, hematoma

Chornic- scars and bony
callus

Treatment- RICE, protection,
may need x-ray if serious
Olecranon Bursitis
 Most common bursitis in the
elbow
 Superficial location
 Acute or chronic- direct
blow MOI
 S&S- pain, warm, point
tender, swelling
 Try conservative Rx firstcold compression
 Aspiration if serious
Strains
 Muscles around elbow
 Excessive restrictive ROM
 Usually from a fall or repeated microtraumas
 X-ray to r/o avulsion or epiphyseal Fx
 RICE, rehabilitation exercises, theraputic ultrasound,
cryotherapy (ice)
Sprains
 Ligaments around the elbow
 Usually from hyperextension of elbow joint
 S&S- pain, shifting of elbow joint, click/pop/snap,
crepitis, tender to palpation, swelling, decrease in
function of elbow
 Cold compress, main concern is ROM, do not massage,
taping may assist in protecting injury
Lateral Epicondylitis

“Tennis Elbow” is
inflammation of extension
muscles at the lateral
epicondyle

Repetitive extension of the
wrist, throwing, microtrauma

S&S- pain during
flexion/extension exercises,
pain may radiate down the
arm, mild swelling, point
tenderness

RICE for actue tendonitis,
chronic- bracing or taping and
rehab
Medial Epicondylitis
 “Golfer’s Elbow” is
inflammation of the flexor
tendons at the medial
epicondyle
 Repetitive flexion of the
wrist, pitching, golf swing
 Same Rx as tennis elbow
Osteochondritis Dissecans
 OCD also occurs in the knee
 Occurs in the bone and
articular cartilage
 Impariment of blood supply,
causes loose bodies in the
joint
 “Locking” joint
 Can require surgery
 Can lead to arthritis
Ulnar Nerve Injuries
 Ulnar nerve is involved
 MOI- friction due to valgus
force at elbow
 Can be caused by
impingment at the elbow
 S&SS- parasthesia down
ulnar side of forearm,
numbness and tingling
 Rx- Avoid pressure, can
require surgery
Dislocation of the Elbow
 FOOSH is a common MOI
 Can dislocate anteriorly,
posteriorlly or laterally
 Olecranon deformity
 Many ligmaents and
tendons can be involved and
may also cause a Fx
 Referral imediately,
reduction by MD, sling,
immobilize in flexion, rehab
Volkman’s Contracture
 Complication of a serious injury
 Causes blood flow problems
 S&S: pain, swelling, muscle spasm, pressure
 Leads to permanaent muscle contracture and permanent
paralysis in servere cases
 Immediate referral
Fractures- Elbow
 Humerus, radius or ulna
 Usually a FOOSH or direct
blow MOI
 Higher rate of injury in
children
 S&S: discoloration, swelling,
muscle spasm, bone
displacement is possible,
swelling and muscle spasm
 Referral for X-ray
Wrist/Hand Injuries
Contusion
 Ulnar side of forearm and wrist at risk
 Can be acute or chronic
 Pain, swelling, hematoma
 Chronic injury can result in scar tissue
 Treatment- RICE, protection through padding
Strains
 Usually from repeated contractions
 Chronic fatigue, irritation in deep forarm muscles and
tissue
 Rx- strengthening though reisistance exercises, rest, heat
and ice, supportive wrap
Fractures
 Common in youths and children
 FOOSH
 Pain, swelling, deformity and a false joint
 Possibility to develop Volkmann’s contratures
 Rx- splint and refer to physician
Colles’ Fx
 Fracture to the distal radius
 FOOSH, hyperextension
 Visible deformity
 Ligaments are usually
involved
 Splint and get an xray
Carpal Tunnel Syndrome
 Anterior aspect of the wrist
 Transverse ligament can be
too tight
 Usually overuse but can be
from a direct blow
 Limited space for structures
 S&S: complain of
numbnress and tingling
de Quervain’s
Tendosynovitis
 Synovial lining becomes
inflammed
 Constant wrist movement
makes this worse
 S&S: aching, radiating pain
in the forearm, pain with
extension of the thumb, may
hear a snap with movement
 Rx: imobilize, ice, rest,
antiinflammatory
medications
Scaphoid Fx
 Most common carpal bone
fracture
 FOOSH
 Can be misdiagnosed as a
sprain
 Poor blood supply to this
bone- can lead to necrosis
 Need to get an xray and
imoblize
Hamate Fx
 MOI: from the handle of a
golf club, tennis racquet or
baseball bat
 S&S: wrist pain, weakness
 Usually needs to be casted
Wrist Ganglion
 Herniation of the joint
capsule or synovial sheath
of a tendon
 Can aslo be a cyst
 Occurs after a wrist sprain
that did not get proper Rx
 Rx: Apply a pressure pad,
surgical removal or draw the
fluid out
Lunate Dx
 Most common bone to
dislocate of the carpal bones
 Usually dislocates anteriorly
 Deformity on the palmar
aspect
 Murphy’s sign
 Reduction by a physician