The Forearm Wrist and Hand Sports Medicine 2

The Forearm, Wrist, and Hand Sports Medicine 2

Anatomy n n Bonesu Metacarpals u Radius and Ulna Musclesu Flexor carpi radialis – flexes and abducts u Flexor carpi ulnaris – flexes and adducts u Extensor carpi radialis (brevis and longus) – extends and abducts u Extensor carpi ulnaris – extends and adducts u Palmaris longus – flexes

Forearm Fractures MOI: u Blow or fall on the outstretched arm n S&S: audible pop or crack, pain, swelling, and disability n TX: RICE, Splinting and casting n

Colles’ Fracture MOI: Fall on outstretched hand n S&S: Forward displacement of the radius, others are same as forearm fracture n TX: RICE, and casting n

Wrist Tenosynovitis MOI: u Repetitive wrist acceleration and deceleration u Inflammation of the sheath around the extensor carpi radialis longus and brevis n S&S: pain (active and passive stretching), tenderness over tendons n TX: Ice massage, NSAIDS, and rest n

Tendonitis MOI: u Overuse of the wrist n S&S: Pain on active or passive stretch and weakness n TX: RICE, NSAIDS n

Carpal Tunnel Syndrome Carpal tunnel is located on the anterior aspect of the wrist n MOI: Repetitive wrist flexion n S&S: Sensory and motor deficits n TX: PRICE, sometime surgery n

De Quervain’s Disease Stenosing tenosynovitis in the thumb n MOI: u Overuse n S&S: u Aching pain n TX: u Immobilization, RICE, NSAIDS n

Dislocation of Lunate Bone n n n MOI: u Forceful hyperextension of the wrist S&S: u Pain, swelling, and difficulty executing wrist and finger flexion TX: u Ice and send to DR. for reduction u If not properly treated necrosis of the bone is likely

Hamate Fracture MOI: u Fall on outstretched arm, racket sports n S&S: u Wrist pain and weakness, and point tenderness n TX: u Cast and padding or removal of hook n

Scaphoid Fracture MOI: u Hyperextension of wrist n S&S: u Pain and point tenderness in “snuff box” n TX: u Surgery to fixate n

Wrist Ganglion n MOI: u Synovial cyst u Usually occurs on the back of wrist after wrist strain S&S: u Occasional pain and a lump TX: u Surgical removal, aspiration, or bursting with pressure pad afterwards

Mallet Finger n n n MOI: u Blow that strikes the tip of the finger causing a jamming or avulsion of the extensor tendon S&S: u Pain on the interphalangeal joint, deformity TX: u RICE and splinting

Boutonniere Deformity n n Extension of DIP AND Flexion of PIP MOI: u Rupture of the extensor tendon dorsal to the middle phalanx S&S: u Severe pain and inability to extend DIP joint TX: u RICE, and splinting

Jersey Finger MOI: u grabbing a jersey or opponent and tendon ruptures n S&S: u DIP joint cannot be flexed n TX: u Surgically repaired n

Gamekeepers Thumb MOI: u UCL Sprain of the thumb u Forced hyperextension n S&S: u Pain, weakness n TX: u RICE, Splint n

Swan Neck Deformity MOI: u Severe hyperextension n S&S: u Pain and swelling in PIP joint n TX: u RICE, splinting in 20 -30 degrees flexion n

Bennett’s Fracture MOI: u Fracture at the carpometacarpal joint u Axial load and abduction n S&S: u Pain and swelling over base of thumb n TX: u Surgery n

Boxer’s Fracture MOI: u Fracture to the 5 th metacarpal n S&S: u Pain, point tenderness, swelling n TX: u Surgery to pin n