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What am I? Articulations of the humerus, radius, and ulna. [ olecranon process ] Medial collateral ligament: 3 portions, anterior, posterior, oblique The anterior fibers are tight in extension, while the posterior fibers are tight in flexion [ beyond 90 degrees ] The posterior fibers are fan shaped and thin when compared to the anterior fibers. Causes: Back Hand Swing (tennis); Painting ; Carrying heavy buckets Lateral Epicondylitis Symptoms: Point tenderness @ lateral epicondyle; radiating pain to mid forearm and into the middle and ring finger; stiffness in elbow. Medial Epicondylitis – Golfer’s Elbow Movements of elbow Elbow: flexion - extension Wrist: supination - pronation - ulnar and radial deviation flexion and extension Flexion and extension originate at the humeroradial and humeroulnar joints while pronation and supination occur from the radio scaphoid (Navicular) articulations at the wrist and the radioulnar joint at the elbow. Elbow Dislocations 6. Dislocations (fractures of the coronoid process occur in approx. 35-40% of elbow dislocations) Dislocations of the elbow are infrequent occurrences in intercollegiate athletics. However, when they do occur, the are often serious injuries due to the potential for fractures and impaired distal circulation. Muscles of elbow, wrist, & hand • • • • • • • Biceps = primary supinator of the forearm also primary for elbow flexion. Brachial, originates on the humerus, extends anteriorly across the joint and inserts into the ulna. Triceps, 3 heads, Primary responsible for extension of elbow. Flexor - pronator group, originates on medial side Extensor - supinator group, Olecranon bursae, separates the skin over the tip of the elbow from the pointed end of the ulna. [ Olecranon process ] Radial - humeral bursae, lies anteriorly between the radial head and the lateral epicondyle between the muscle attachments Hand & Wrist Injuries • • • • • • • • Gamekeeper’s Thumb Mallet Finger Jersey Finger Central Slip Injury / Boutenniere Deformity Swan Neck Deformity Colles Fracture / Smith Fracture Scaphoid Fracture Bennet’s Fracture • Boxer’s Fracture • Dislocated Fingers • Smash/Avulsion Injuries Gamekeeper’s Thumb Normal thumb Normal Carrying Angle Gamekeeper’s Sprain (Notice the opening of joint Mallet Finger How ? Hit on tip of finger with ball S/S? Tip of Finger Drops Blood under nail Swelling Tx? PRICE, Splint into ext., Need to refer within a week Mallet Finger Jersey Finger How? – Flexor tendon rupture Finger caught in jersey S/S? Unable to actively flex finger at DIP or PIP joint DIP represents Profundus rupture PIP represents Superficialis rupture TX? Surgery Splint Jersey Finger Swan Neck Deformity Swan Neck Deformity •DIP goes into extension •PIP goes into flexion Central Slip Injury / Boutenniere Deformity How? PIP forceabley flexed and extended @ same time Common in Basketball Players S/S? Unable to actively extend the joint Tenderness over the dorsal aspect of the middle phalanx Tx? Splint in full extension x 6 weeks Central Slip Injury / Boutenniere Deformity Colles Fracture What? TX? Distal Radial Fracture PRICE Most common arm fracture Refer to MD How? Fall on outstretched hand Wrist goes into extension S/S? immediate (acute) pain, tenderness, bruising, and swelling Frequently, the wrist hangs in an odd or bent way (deformity). Cast if no surgery Surgery possible Colles Fracture Smith Fracture What? Distal Radial Fracture How? Fall on flexed hand S/S? Same as Colles Fracture TX? Same as Colles Fracture Scaphoid Fracture What? Fracture small carpal bone 2nd most common wrist fracture How? Fall on outstretched hand S/S? Swelling Point tenderness (anatomical snuff box) TX? Refer for xray – CYA!!! Bennett’s Fracture Fracture of 1st MCP jt Fall on outstretched hand Dropped object TX Refer for xray Splint Boxer’s Fracture Break in the small end of the 5th metacarpal What caused it? Punching something harder than the hand, such as a wall or another person's head. TX? PRICE REFER Dislocated Fingers During sports activities, a basketball or baseball may strike the tip of an outstretched finger. Your finger might get caught in equipment such as a game jersey or pads. You might fall onto your outstretched hand. Dislocated Finger S/S Do Not Try to Reduce! Obvious Deformity Splint Pain Refer Swelling Smash / Avulsion Injury Smash / Avulsion Injury 3 months post op