Chapter 19 The Elbow, Forearm, Wrist and Hand.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Anatomy of the Wrist, Hand and Fingers Assessment of the Wrist, Hand and Fingers History Past history Mechanism of injury When does it hurt? Type of, quality of, duration of, pain? Sounds or feelings? How long were you disabled? Swelling? Previous treatments? Observation Postural deviations Is the part held still, stiff or protected? Wrist or hand swollen or discolored? General attitude What movements can be performed fully and rhythmically? Thumb to finger touching Color of nailbeds Palpation: Bony Palpate for pain and deformity Be sure to palpate all the bones of wrist and hand during the evaluation Soft tissue palpation should include the tendons crossing the wrist and the muscles involved in movement of the thumb as well as the digits Recognition and Management of Injuries to the Wrist, Hand and Fingers Wrist Sprains Cause of Injury Most common wrist injury Arises from any abnormal, forced movement Falling on hyperextended wrist, violent flexion or torsion Signs of Injury Pain, swelling and difficulty w/ movement Care Refer to physician for X-ray if severe RICE, splint and analgesics Have athlete begin strengthening soon after injury Tape for support can benefit healing and prevent further injury Wrist Tendinitis Cause of Injury Primary cause is overuse of the wrist Repetitive wrist accelerations and decelerations Signs of Injury Pain on active use or passive stretching Tenderness and swelling over involved tendon Care Acute pain and inflammation treated w/ ice massage 4x daily for first 48-72 hours, NSAID’s and rest Use of wrist splint may protect injured tendon PRE can be instituted once swelling and pain subsided (high rep, low resistance) Carpal Tunnel Syndrome Cause of Injury Compression of median nerve due to inflammation of tendons and sheaths of carpal tunnel Result of repeated wrist flexion or direct trauma to anterior aspect of wrist Signs of Inju