Transcript The Elbow. Forearm, Wrist, and Hand

The Elbow, Forearm, Wrist,
and Hand
Chapter 19
Elbow Anatomy
Bones
Articulations
Ligaments and Capsule
Synovium and Bursa
Musculature
Nerve Supply
Blood Supply
Functional Anatomy
Preventing/Assessing
Elbow
Injuries
History
Observation
Palpation (bony and soft tissue)
Special Tests
Tinel sign
Test for capsular injury
Valgus and Varus tests
Medial and Lateral Epicondylitis Test
Pinch Grip test
Pinch Grip Test
Pronator Test syndrome test
 Functional Evaluation
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
Recognition and Management of
Injuries
 Contusion
Etiology
Signs and Symptoms
Management
 Olecranon Bursitis
Etiology
Signs and Symptoms
Management
 Strains
Etiology
Signs and Symptoms
Management
 Elbow Sprains
Etiology
Signs and Symptoms
Management
 Lateral Epicondylitis
Etiology
Signs and Symptoms
Management
 Medial Epicondylitis
Etiology
Signs and Symptoms
Management
Recognition and Management of
Injuries (contd.)
 Elbow Osteochondritis
Dissecans
Etiology
Signs and Symptoms
Management
 Little League Elbow
Etiology
Signs and Symptoms
Management
 Cubital Tunnel Syndrome
Etiology
Signs and Symptoms
Management
 Elbow Dislocation
Etiology
Signs and Symptoms
Management
 Fracture of the Elbow
Etiology
Signs and Symptoms
Management
 Volkmann’s Contracture
Etiology
Signs and Symptoms
Management
Rehabilitation Principles
for the Elbow
 Phase I - immobilization (maintain wrist and hand
strength) - 6 weeks
 Phase II - Increase ROM (after cast removal)
Therapy: Ice (5 to 15 minutes)
Exercise: PREs in all directions
 General Body Conditioning
 Joint mobilization
 Flexibility
 Strengthening
 Functional Progression
 Return to Activity
 Protective Taping and Bracing
Forearm Anatomy
 Radius and Ulna: Elbow
Joints: radioulnar joint (superior, middle,
and distal)
 Bone: proximal radial head, olecranon process,
radial shaft, ulnar shaft, distal radius, radial
styloid process, ulnar head, ulnar styloid
 Musculature: Forearm, flexors, pronators,
extensors, and supinators
 Nerve/Blood Supply: median and radial nerve
and brachial, radial, and ulnar artery
Forearm Assessment
History
Observation
Palpation
Special Tests
Recognition and
Management of Forearm
Injuries
Contusion
Etiology
Signs and Symptoms
Management
 Forearm Splints
Etiology
Signs and Symptoms
Management
Colles’ fracture
Etiology
Signs and Symptoms
Management
 Forearm Splints
Etiology
Signs and Symptoms
Management
Wrist, Hand, and Finger
Anatomy
Bones: carpals and metacarpals
Joints: radiocarpal, carpal, metacarpal, and
phalangeal joints
Ligaments: “many at each joint in the hand”
Musculature: “many intrinsic and extrinsic
muscles”
Blood and Nerve Supply: ulnar, median, radial
nerve and radial and ulnar superficial and deep
palmar arch arteries
Assessment of Wrist,
Hand, and Finger Injuries
 History
 Observation
 Palpation
 Special Tests: Finklestein’s test, Tinel’s Sign,
Phalen’s test, valgus and varus stress test, Glide
test, Lunotriquetral Ballotment test
 Circulatory and Neurological Evaluation
Allen test
 Functional Evaluation
Recognition and Management
of Wrist, Hand, and Finger
Injuries
 Wrist Sprain
Etiology
Signs and Symptoms
Management
 Triangular Fibrocartilage
Complex Injury
Etiology
Signs and Symptoms
Management
 Carpal tunnel syndrome
Etiology
Signs and Symptoms
Management
 Tenosynovitis
Etiology
Signs and Symptoms
Management
 Tendinitis
Etiology
Signs and Symptoms
Management
 Nerve Compression,
Entrapment, Palsy
Etiology
Signs and Symptoms
Management
Recognition and Management
of Wrist, Hand, and Finger
Injuries
 De Quervain’s Disease
Etiology
Signs and Symptoms
Management
 Dislocation of the Lunate
Bone
Etiology
Signs and Symptoms
Management
 Scaphoid Fracture
Etiology
Signs and Symptoms
Management
 Hamate Fracture
Etiology
Signs and Symptoms
Management
 Wrist Ganglion
Etiology
Signs and Symptoms
Management
Recognition and Management
of Wrist, Hand, and Finger
Injuries
 Contusion to hand and
fingers
Etiology
Signs and Symptoms
Management
 Bowler’s Thumb
Etiology
Signs and Symptoms
Management
 Jersey finger
Etiology
Signs and Symptoms
Management
 Trigger finger or thumb
Etiology
Signs and Symptoms
Management
 Mallet finger
Etiology
Signs and Symptoms
Management
 Boutonniere deformity
Etiology
Signs and Symptoms
Management
Recognition and Management
of Wrist, Hand, and Finger
Injuries
 Dupuytren’s Contracture
Etiology
Signs and Symptoms
Management
 Sprains, Dislocations, and
Fractures
Etiology
Signs and Symptoms
Management
 Gamekeeper’s Thumb
Etiology
Signs and Symptoms
Management
 Sprains PIP and DIP joint
Etiology
Signs and Symptoms
Management
 Swan neck deformity
Etiology
Signs and Symptoms
Management
 PIP Dorsal dislocation
Etiology
Signs and Symptoms
Management
Recognition and Management
of Wrist, Hand, and Finger
Injuries
 MCP dislocation
Etiology
Signs and Symptoms
Management
 Metacarpal fracture
Etiology
Signs and Symptoms
Management
 Bennett’s Fracture
Etiology
Signs and Symptoms
Management
 Distal/Middle/Proximal
phalangeal fracture
Etiology
Signs and Symptoms
Management
 Fingernail deformity
Etiology
Signs and Symptoms
Management
Rehabilitation Principles for
the Forearm, Wrist, Hand, and
Fingers
General Body Conditioning
Joint Mobilization
Flexibility
Strength
Neuromuscular Control
Return to Activity