Transcript Wrist and Hand Injuries

Wrist and Hand Injuries
Objectives:
 Understand basic
anatomy of wrist
 Explain various types
of injuries
 Understand common
mechanisms that
cause injuries to wrist
and hand
 Understand signs and
symptoms of various
fractures of wrist and
hand
Anatomy of Wrist
The wrist is the joint between the
arm and the hand. It is made up of
seven irregularly shaped carpal
bones that articulate between the
radius and the ulna of the arm and
the metacarpals of the hand to allow
wrist movement.
Bones of Wrist and Hand
Radius and Ulna
Carpals
Trapezium
Trapezoid
Scaphoid
Lunate
Triquetral
Pisiform
Capitate
Hamate
Metacarpals
Movements of the Wrist
Ulnar Deviation
Radial Deviation
Hyperextension
Extension
Flexion
Preventing Wrist Injuries
Protective Equipment
Braces
Tape
Gloves
Padding
Stretching and Strengthening
Types of Wrist and Hand Injuries
Wrist Sprains
– Over use
– Falls
– Forceful Twisting
Signs & Symptoms
-Pain
-Decreased ROM
-Decreased Grip Strength
-Some swelling
Treatment
PRICE
Reestablishing ROM and Strength
Dislocation of the Lunate
Occurs due to falling on
hand that is either in
extension or flexion.
Signs & Symptoms
Deformity
Pain
Swelling
Decreased ROM
Treatment
Splint and refer to DR.
Gamekeepers Thumb
Injury to medial collateral
ligament of the thumb by
forcing the thumb into
abduction
Signs & Symptoms
Pain
May swell
Treatment
Splinting
Ice
Refer to Dr.
Interphalangeal Collateral Ligament
Sprains
Stressing a collateral ligament on the
phalanges beyond normal ROM.
Signs & Symptoms
Swelling
Discolored
Treatment
Ice
Refer to Dr
Dislocation of the interphalangeal
Joint or Metacarpal Phalangeal Joint.
Signs & Symptoms
Swelling
Loss of motion
Treatment
Ice
Refer to Dr
Tendonitis
Inflammation of the
tendon
Caused by – overuse,
stretching or an
impact
Prevent by –
increasing strength
and flexibility, use
padding, and by
avoiding repetitive
injuries.
De Quervain’s Tendonitis
Affects the abductor
pollicis longus and
extensor pollicis brevis.
Shot putters who hold the
shot while the wrist is in
radial deviation are prone
to this condition.
Signs & Symptoms
Difficulty with abduction,
swelling and crepitus.
Treatment
with discontinuation the
repetitive movement and
PRICE
Mallet Finger
Fingertip receiving an impact.
Impact causes the extensor
tendon to be torn from the
bone.
Signs & Symptoms
Fingertip is in flexion
Unable to lift fingertip to
straighten
Pain, and some swelling
Treatment
Splint into extension
Refer to Dr.
– Dr. may surgically repair or
leave splinted to allow tendon
to reattach
Jersey Finger
Similar to mallet finger except that the flexor
tendon tears from the fingertip.
Occurs when the DIP joint is forcibly flexed, such
as when the athlete is holding an opponent’s
jersey with a fist, and his finger is forced to
extend, which tears the tendon.
Signs & Symptoms
Unable to flex the DIP joint
Pain and swelling
Treatment
Splint and ice
Refer to Dr.
Boutonniere Deformity
Caused by hard impact
over the PIP joint
which causes the
extensor tendon to fall
laterally.
Signs & Symptoms
Unable to extend the
PIP joint
Pain and swelling
Treatment
Splint and Ice
Refer to Dr.
Bone Injuries
Caused by direct impact
Swelling, pain, deformity and
disability are common
Two complications
Non union
Avascular Necrosis – Death due to
lack of blood supply