The Elbow, Forearm, Wrist and hand

Main Anatomy Phalanges Phalanges Metacarpals Metacarpals Carpal Carpal Radius Radius Ulna Ulna Humerus Humerus

Carpals How many bones make up the wrist? How many bones make up the wrist? 8 The wrist is formed where the distal aspect of the radius and the ulna joins. There are eight carpal bones in all. The carpal bones are gliding joints and are stabilized by anterior, posterior, and connecting ligaments. The wrist is formed where the distal aspect of the radius and the ulna joins. There are eight carpal bones in all. The carpal bones are gliding joints and are stabilized by anterior, posterior, and connecting ligaments.

Muscles of the arm Forearm main muscles: carpi ulnaris brachioradialis muscles of forearm muscles of forearm

Elbow Dislocation Occurs when athlete falls on an outstretched hand, or a direct blow Occurs when athlete falls on an outstretched hand, or a direct blow Radius and Ulna are forced away from humerus Radius and Ulna are forced away from humerus Take immediately to hospital Take immediately to hospital –Why? –Danger of damage to blood vessels and nerves that can lead to paralysis of fingers –Splint as is, and apply cold To help with prevention of injury, teach athletes correct way to fall/tumble (gymnastics) To help with prevention of injury, teach athletes correct way to fall/tumble (gymnastics)

Elbow Dislocation

Elbow Hyperextension When the elbow is extended past normal range When the elbow is extended past normal range Falling onto an outstretched hand Falling onto an outstretched hand –Athlete is normally apprehensive of straightening the arm S/S: S/S: –Swollen area 1 st Aid 1 st Aid –Cold and Compression and elevation (if possible) Start mild ROM exercises asap Start mild ROM exercises asap

Elbow Hyperextension

Little League Elbow Cause: Cause: –Too much stress on the elbow –When muscle is stronger than the bone Muscle pulls away a chip of bone Muscle pulls away a chip of bone Occurs in children who have not gone through puberty yet Occurs in children who have not gone through puberty yet Repetitive throwing motions Repetitive throwing motions Prevention Prevention –Try to reduce the amount of throwing motions –Stop at the first sign of pain

Little League Elbow

Tennis Elbow Tennis Elbow - Sports Injury Clinic Tennis Elbow - Sports Injury Clinic Tennis Elbow - Sports Injury Clinic Tennis Elbow - Sports Injury Clinic Causes: Causes: –Poor technique –Inadequate warm-up –overuse

Wrist Sprains One of the most common injuries One of the most common injuries Landing on wrist, collision with another athletes Landing on wrist, collision with another athletes Ask is athlete heard a “pop”, look for deformity and swelling Ask is athlete heard a “pop”, look for deformity and swelling 1 st aid 1 st aid –ICE Taping can help prevent further injury Taping can help prevent further injury

Wrist Sprain TX Wrist Sprain - Sports Injury Clinic Wrist Sprain - Sports Injury Clinic Wrist Sprain - Sports Injury Clinic Wrist Sprain - Sports Injury Clinic Wrist Taping Wrist Taping Wrist Taping Wrist Taping

Wrist Fracture Happen to the radius, ulna and one bone from the carpal Happen to the radius, ulna and one bone from the carpal –The navicular Same mechanisms as sprain Same mechanisms as sprain Make sure it is not a sprain, or it can lead to necrosis, death of the bone Make sure it is not a sprain, or it can lead to necrosis, death of the bone Look for swelling and point tenderness at the navicular Look for swelling and point tenderness at the navicular Splint and apply ice Splint and apply ice

Sprained Thumb Most common in basketball and football Most common in basketball and football Ball hits the end of the thumb when trying to catch it Ball hits the end of the thumb when trying to catch it The joint that is injured: The joint that is injured: –MCP joint (metacarpophalangeal joint) –MCP joint MCP jointMCP joint Swelling and pain at base of thumb Swelling and pain at base of thumb Try to pinch thumb and first finger together Try to pinch thumb and first finger together 1” elastic tape is best material to use to tape 1” elastic tape is best material to use to tape

Thumb sprain

Taping for sprained Thumb Thumb Sprain Taping - Sports Injury Clinic Thumb Sprain Taping - Sports Injury Clinic Thumb Sprain Taping - Sports Injury Clinic Thumb Sprain Taping - Sports Injury Clinic

Jammed Finger Ball striking end of finger is most common MOI Ball striking end of finger is most common MOI What joint is most commonly sprained? What joint is most commonly sprained? –PIP joint (proximal interphalangeal joint) S/S: S/S: –Swelling and soreness localized to that joint TX TX –Compression and Ice –Elastic tape is best way to maintain compression –Use wood or metal splint to immobilize joint –Protect by “buddy” taping. Taping it to the stronger adjacent finger. Try to put foam between fingers if available

Jammed fingers

Dislocated Fingers Volleyball and Football Volleyball and Football Direct blow to tip of finger Direct blow to tip of finger Usually which joint? Usually which joint? –Middle phalangeal joint Splint as is Splint as is Apply cold Apply cold Physician Physician