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 EpicondylitisSymptoms: 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 - extensionWrist: 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?

Distal Radial Fracture Most common arm fracture

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).

TX? PRICE Refer to MD 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

Do Not Try to Reduce!

Splint Refer

S/S Obvious Deformity Pain Swelling

Smash / Avulsion Injury

Smash / Avulsion Injury

3 months post op