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The Elbow, Forearm, Wrist and hand Main Anatomy • • • • • • Phalanges Metacarpals Carpal Radius Ulna Humerus Carpals • How many bones make up the wrist? • 8 • The wrist is formed where the distal aspect of the radius and the ulna joins. There are eight carpal bones in all. The carpal bones are gliding joints and are stabilized by anterior, posterior, and connecting ligaments. Muscles of the arm Forearm main muscles: carpi ulnaris brachioradialis muscles of forearm Elbow Dislocation • Occurs when athlete falls on an outstretched • • hand, or a direct blow Radius and Ulna are forced away from humerus Take immediately to hospital – Why? – Danger of damage to blood vessels and nerves that can lead to paralysis of fingers – Splint as is, and apply cold • To help with prevention of injury, teach athletes correct way to fall/tumble (gymnastics) Elbow Dislocation Elbow Hyperextension • When the elbow is extended past normal range • Falling onto an outstretched hand – Athlete is normally apprehensive of straightening the arm • S/S: – Swollen area • 1st Aid – Cold and Compression and elevation (if possible) • Start mild ROM exercises asap Elbow Hyperextension Little League Elbow • Cause: – Too much stress on the elbow – When muscle is stronger than the bone • Muscle pulls away a chip of bone • Occurs in children who have not gone through • • puberty yet Repetitive throwing motions Prevention – Try to reduce the amount of throwing motions – Stop at the first sign of pain Little League Elbow Tennis Elbow • Tennis Elbow - Sports Injury Clinic • Causes: – Poor technique – Inadequate warm-up – overuse Wrist Sprains • One of the most common injuries • Landing on wrist, collision with another athletes • Ask is athlete heard a “pop”, look for deformity and swelling • 1st aid – ICE • Taping can help prevent further injury Wrist Sprain TX • Wrist Sprain - Sports Injury Clinic • Wrist Taping Wrist Fracture • Happen to the radius, ulna and one bone from the carpal – The navicular • Same mechanisms as sprain • Make sure it is not a sprain, or it can lead to necrosis, death of the bone • Look for swelling and point tenderness at the navicular • Splint and apply ice Sprained Thumb • Most common in basketball and football • Ball hits the end of the thumb when trying to • • • • catch it The joint that is injured: – MCP joint (metacarpophalangeal joint) – MCP joint Swelling and pain at base of thumb Try to pinch thumb and first finger together 1” elastic tape is best material to use to tape Thumb sprain Taping for sprained Thumb • Thumb Sprain Taping - Sports Injury Clinic Jammed Finger • Ball striking end of finger is most common MOI • What joint is most commonly sprained? – PIP joint (proximal interphalangeal joint) • S/S: – Swelling and soreness localized to that joint • TX – – – – Compression and Ice Elastic tape is best way to maintain compression Use wood or metal splint to immobilize joint Protect by “buddy” taping. Taping it to the stronger adjacent finger. Try to put foam between fingers if available Jammed fingers Dislocated Fingers • Volleyball and Football • Direct blow to tip of finger • Usually which joint? – Middle phalangeal joint • Splint as is • Apply cold • Physician