Care and Prevention of athletic injuries Chapter 12 Ms. K Hand &Wrist Care and Prevention of athletic injuries Chapter 12 Ms. K

WRIST & HAND ANATOMY Fingers named by #1-5 starting at the thumb Joints named after the bones that come together Muscles: Wrist extensors are posterior on the forearm Wrist flexors are anterior on the forearm

WRIST & HAND ANATOMY Ligaments: Triangular fibrocartilage complex Every finger has 2 collateral ligaments Radial/lateral collateral ligament Ulnar/Medial collateral ligament Triangular fibrocartilage complex

Anatomical Snuff Box The boundaries The posterior border of the snuffbox is the tendon of the extensor pollicis longus. The anterior border are the extensor pollicis brevis and the abductor pollicis longus.[1] The proximal border is formed by the styloid process of the radius The floor of the snuffbox varies depending on the position of the wrist, but both the trapezium and primarily the scaphoid can be palpated.

TFCC The Triangular fibrocartilage complex (TFCC) is formed by: Triangular fibrocartilage discus (TFC) Radioulnar ligaments (RUL’s) Ulnocarpal ligaments (UCL’s).

DeQuervain’s Tendonitis Tendonitis of the abductor pollicus longus and extensor pollicus brevis (muscles that move that thumb) AKA as “Trigger Finger” MOI: Repetitive motion (radial deviation) of the wrist Signs/Symptoms: Pn with abduction Swelling Crepitus Treatment: RICE NSAIDS Strengthening of hand muscles

Mallet Finger MOI: Hit at the tip of the finger Extensor tendon tears from bone Signs/Symptoms: Finger is in flexion Cannot straighten finger because tendon is unattached Management: Pain Swelling Splint in extension Surgery to reattach

Jersey Finger Flexor tendon tears away from fingertip MOI: DIP jt is in flexion and is suddenly forced to extend (i.e. grabbing a jersey) Signs/Symptoms: Pain Swelling DIP jt is unable to flex Management: Splint Ice Surgery

Wrist Sprain Management: MOI: FOOSH Excessive radial/ulnar deviation Signs/Symptoms Pain Decreased ROM Decreased grip strength Swelling Laxity Management: RICE Splint Rehab to strengthen hand muscles

Ganglion Cyst Occurs when the sheath covering the muscles becomes filled with fluid A.K.A. “Bible’s cyst” Signs/Symptoms: Bubble develops on wrist Painful at times Management: Ice with compression If persistent, needs to be drained by physician

Gamekeeper’s Thumb MOI: Injury to medial collateral ligament of thumb due to forced abduction (i.e. catching a basketball) Signs/Symptoms: Pain Swelling Loss of ROM Management: Ice Splint Xray to r/o fx

Interphalangeal Collateral Ligament Sprain MOI: Joint is stressed beyond normal limits I.e. finger hits a ball, land with fingers extended or curled Signs/Symptoms: Pain Swollen Ecchymosis Loss of ROM Management: XRAY to r/o fx Ice in ice cup Splint

Dislocation of Interphalangeal or Metacarpophalangeal Joints MOI: Bones of joint are forced in opposite directions Signs/Symptoms: Obvious deformity Pain, Swelling Ecchymosis Loss of ROM Management: Refer to physician for reduction