Injuries to Skeletal System and Joints

Classification of Bones Long –femur, humerus Short –carpals, tarsals Flat –frontal, sternum Irregular –vertebral

Bones of the Cranium

Bones of the Rib Cage

Bones of the Vertebral Column

Bones of the Upper Extremity

Bones of the Lower Extremity

Anatomy of Long Bones Epiphysis –ends Metaphysis –“growth plate” area –epiphysis meets diaphysis Diaphysis –Shaft or axis

Fractures Fractures (fx) –Break or crack in bones 2 types –Compound Breaks the skin –Simple Does not break the skin Most fx in sports are simple

Types of Fractures Oblique - goes at angle to the axis Comminuted - many relatively small fragments - “blow out” fx Spiral - fracture which runs around axis of bone - “s” shaped

Types of Fractures Greenstick - incomplete fracture where the bone bends Transverse - goes across the bone's axis

Fractures Avulsion –fragment of bone is pulled away where tendon attaches –Common site Superior pelvic bone Stress –small crack in bone caused by repeated stress over time –Common site Tibia 5 th metatarsal

Treatment of Fractures Compound 1. Medical emergency 2.Control bleeding 3.Call EMS 4.Apply splint if can 5.Avoid any unnecessary movement 6.Will require surgery

Compound Fracture

Fracture of Forearm

Greenstick Fracture

Displaced Fracture

Transverse Fracture

Oblique Fracture

Stress Fracture

Avulsion Fracture

Treating a Fx Determine if EMS is needed –Compound fx ? –Severe deformity ? Splint fx –Type of splint based on severity of fx Apply ice if can Send to ER or Dr. office for x-ray

Types of Splints Splints –Sam splints –Vacuum splints –Air splints –Traction splints

Joints / Articulations Articulations –a joint; the point at which two bones meet –Over 230 articulations in the body

Joints / Articulations 3 categories –Fibrous –Cartilaginous –Synovial

Categories of Joints 1.Fibrous –Immovable joints –Examples bones in the cranium (sutures) syndesmosis –connective tissue between tibia and fibula AND radius and ulna

Categories of Joints 2. Cartilaginous –Slightly moveable –Examples Vertebrae Joint between clavicle and sternum Ribs and sternum Pubis Symphysis –Between pelvic bones

Categories of Joints 3. Synovial –Freely movable –Most common joint in the body –Examples elbow knee fingers shoulder

Classification of Joints Classification of Joints

Motion Groups for Synovial Joints Ball and socket –Shoulder –Hip Pivot –Atlas & axis (1 st & 2 nd cervical vertebra)

Motion Groups for Synovial Joints Hinge –Elbow –Knee –Phalangeal joints Saddle –Thumb

Motion Groups for Synovial Joints Condyloid –Wrist (carpal and radius) –Metacarpals and proximal phalange Gliding –Carpals –Tarsals

Motion Groups of Synovial Joints Synovial Joints

Anatomy of a Synovial Joint Ligaments –connects bone to bone Synovial Membrane –encloses joint capsule Synovial Fluid –colorless fluid within the joint capsule Meniscus –cartilaginous disc inside the joint

Anatomy of a Synovial Joint Bursa –sac of synovial fluid between tendons, bones, and ligaments Articular cartilage –on end of long bones Synovial fluid, meniscus, and bursa sacs: 1. reduce friction between joints 2. cushions 3. acts as a shock absorber

Anatomy of Synovial Joints

Bursa Sacs

Ligament or Capsular Sprains Sprain –overstretching and/or tearing of ligaments or other connective tissue Mechanism of injury –traumatic twisting –can include joint capsule or synovial membrane

Symptoms of Joint Sprain 1. Deformity 2. Crepitation – cracking or grating sound 3. Point Tenderness 4. Immediate Swelling

Degrees of Joint Sprains 1 st degree – –minor tearing of ligaments –mild point tenderness –mild loss of strength –no joint laxity –no decrease in range of motion (ROM) Range of Motion (ROM) –the max range through which a joint can move

Degrees of Joint Sprains 2 nd Degree – –partial tearing of ligaments –swelling and tenderness –decreased range of motion –moderate loss of strength –some joint laxity

Degrees of Joint Sprains 3 rd Degree –complete tearing of ligaments –complete loss of function –severe swelling –increased laxity –immobilize and send to physician –will be in walking boot

Degrees of Sprains

Treatment of Sprains PRICE 1. Protect –avoids further injury 2. Rest 3. Ice –20 minutes on / 45 minutes off 4. Compression – use elastic wrap 5. Elevate –raise above level of heart

Treatment of Sprains Follow-up strengthening exercises –ROM exercises –Therabands –Wobble boards wrapping and bracing

Common Sites for Sprains Shoulder Elbow Wrist Knee Ankle

Dislocations and Subluxations Dislocation –separation of a joint and malposition of an extremity –joint goes beyond normal limits Subluxation –partial dislocation –“slipped out and went back in”

Symptoms of Dislocation 1. Point tenderness 2. Loss of Strength 3. Complete loss of ROM 4. Swelling and Deformity

Treatment of Dislocations 1. Check area below for pulse 2. If pulse impaired, call Splint injury in most comfortable position 4. Apply ice 5. All cases have athlete see physician Follow-up - strengthening and flexibility exercises MOI for Elbow Dislocations

Dislocated Humeral Head

Dislocated Thumb

Dislocated Tibia / Fx Fibula

Dislocated Ulna

Dislocated Thumb

Synovitis and Bursitis Bursitis –inflammation of bursa sac Synovitis –inflammation of synovial membrane (lining of joint) *** Both caused by repetitive motions (overuse injuries)

Treatment of Synovitis and Bursitis 1. If swelling is present -- ICE technique 2. No swelling – deep heating Follow-up – stretching ROM exercises pain persists, see physician

Bursitis of the Elbow

Petallar and Calcaneal Brusitis

Calcaneal Bursitis

Bursitis Health Byte Elbow (Olecrenon) BursitisElbow (Olecrenon) Bursitis Knee Bursitis (Prepatellar bursitis)Knee Bursitis (Prepatellar bursitis) Synovitis of the Shoulder