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Injuries to Skeletal System and Joints
Classification of Bones
• Long – femur, humerus
• Short– carpals, tarsals
• Flat– frontal, sternum
• Irregular– vertebral
Bones of the Cranium
Bones of the Rib Cage
Bones of the Vertebral Column
Bones of the Upper Extremity
Bones of the Lower Extremity
Anatomy of Long Bones
• Epiphysis– ends
• Metaphysis– “growth plate” area– epiphysis meets
diaphysis
• Diaphysis– Shaft or axis
Fractures
• Fractures (fx)– Break or crack in
bones
• 2 types– Compound
• Breaks the skin
– Simple• Does not break the skin• Most fx in sports are
simple
Types of FracturesOblique
- goes at angle to the axis
Comminuted - many relatively small fragments - “blow out” fx
Spiral - fracture which runs around axis of bone- “s” shaped
Types of Fractures
Greenstick - incomplete fracture where the bone bends
Transverse - goes across the bone's axis
Fractures
• Avulsion – fragment of bone is
pulled away where tendon attaches
– Common site• Superior pelvic bone
• Stress– small crack in bone
caused by repeated stress over time
– Common site• Tibia
• 5th metatarsal
Treatment of Fractures
• Compound1. Medical emergency
2. Control bleeding
3. Call EMS
4. Apply splint if can
5. Avoid any unnecessary movement
6. Will require surgery
Compound Fracture
Fracture of Forearm
Greenstick Fracture
Displaced Fracture
Transverse Fracture
Oblique Fracture
Stress Fracture
Avulsion Fracture
Treating a Fx
• Determine if EMS is needed– Compound fx ?– Severe deformity ?
• Splint fx– Type of splint based on
severity of fx
• Apply ice if can• Send to ER or Dr.
office for x-ray
Types of Splints
• Splints– Sam splints– Vacuum splints– Air splints– Traction splints
Joints / Articulations
• Articulations – a joint; the point at
which two bones meet– Over 230 articulations
in the body
Joints / Articulations
• 3 categories– Fibrous– Cartilaginous– Synovial
Categories of Joints
1. Fibrous – Immovable joints– Examples
• bones in the cranium (sutures)
• syndesmosis– connective tissue
between tibia and fibula AND radius and ulna
Categories of Joints
2. Cartilaginous – Slightly moveable– Examples
• Vertebrae• Joint between clavicle
and sternum• Ribs and sternum• Pubis Symphysis
– Between pelvic bones
Categories of Joints
3. Synovial– Freely movable– Most common joint in the
body– Examples
• elbow• knee• fingers• shoulder
Classification of Joints
• Classification of Joints
Motion Groups for Synovial Joints
• Ball and socket – Shoulder– Hip
• Pivot– Atlas & axis (1st & 2nd cervical
vertebra)
Motion Groups for Synovial Joints
• Hinge– Elbow– Knee– Phalangeal joints
• Saddle– Thumb
Motion Groups for Synovial Joints
• Condyloid– Wrist (carpal and radius)– Metacarpals and
proximal phalange
• Gliding– Carpals– Tarsals
Motion Groups of Synovial Joints• Synovial Joints
Anatomy of a Synovial JointAnatomy of a Synovial Joint
• Ligaments– connects bone to bone
• Synovial Membrane– encloses joint capsule
• Synovial Fluid– colorless fluid within the
joint capsule
• Meniscus – cartilaginous disc inside
the joint
Anatomy of a Synovial JointAnatomy of a Synovial Joint• Bursa
– sac of synovial fluid between tendons, bones, and ligaments
• Articular cartilage– on end of long bones
Synovial fluid, meniscus, and bursa sacs:1. reduce friction between joints
2. cushions3. acts as a shock absorber
• Anatomy of Synovial Joints
Bursa Sacs
Ligament or Capsular Sprains
• Sprain – overstretching and/or
tearing of ligaments or other connective tissue
• Mechanism of injury– traumatic twisting– can include joint capsule
or synovial membrane
Symptoms of Joint Sprain
1. Deformity
2. Crepitation – cracking or grating sound
3. Point Tenderness
4. Immediate Swelling
Degrees of Joint Sprains
1st degree – – minor tearing of
ligaments– mild point tenderness– mild loss of strength– no joint laxity – no decrease in range
of motion (ROM)
Range of Motion (ROM)– the max range through
which a joint can move
Degrees of Joint Sprains
• 2nd Degree – – partial tearing of ligaments– swelling and tenderness– decreased range of motion– moderate loss of strength– some joint laxity
Degrees of Joint Sprains
• 3rd Degree – complete tearing of
ligaments– complete loss of
function– severe swelling– increased laxity – immobilize and send
to physician– will be in walking boot
Degrees of Sprains
Treatment of SprainsPRICE
1. Protect– avoids further injury
2. Rest 3. Ice – 20 minutes on / 45
minutes off
4. Compression– use elastic wrap
5. Elevate – raise above level of
heart
Treatment of Sprains
Follow-up • strengthening exercises
– ROM exercises– Therabands– Wobble boards
• wrapping and bracing
Common Sites for Sprains
• Shoulder• Elbow• Wrist• Knee• Ankle
Dislocations and Subluxations
• Dislocation – separation of a joint
and malposition of an extremity
– joint goes beyond normal limits
• Subluxation – partial dislocation– “slipped out and went
back in”
Symptoms of Dislocation
1. Point tenderness
2. Loss of Strength
3. Complete loss of ROM
4. Swelling and Deformity
Treatment of Dislocations
1. Check area below for pulse2. If pulse impaired, call 9113. Splint injury in most
comfortable position4. Apply ice5. All cases have athlete see
physician
Follow-up - strengthening and flexibility exercises
MOI for Elbow Dislocations
Dislocated Humeral Head
Dislocated Thumb
Dislocated Tibia / Fx Fibula
Dislocated Ulna
Dislocated Thumb
Synovitis and Bursitis• Bursitis
– inflammation of bursa sac
• Synovitis– inflammation of synovial
membrane (lining of joint)
*** Both caused by repetitive motions (overuse injuries)
Treatment of Synovitis and Bursitis
1. If swelling is present -- ICE technique
2. No swelling – deep heating
Follow-up – stretching
ROM exercises
pain persists, see physician
Bursitis of the Elbow
Petallar and Calcaneal Brusitis
Calcaneal Bursitis
• Bursitis Health Byte• Elbow (Olecrenon)
Bursitis• Knee Bursitis (Prepatellar
bursitis)• Synovitis of the Shoulder