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Elbow, Wrist, and Hand Injuries: Anatomy, Injuries, and Treatment

This chapter explores the major components of the elbow, wrist, and hand, as well as common injuries and conditions associated with these areas. It provides an overview of fractures, dislocations, tendonitis, nerve impingement, and more. By understanding the anatomy and mechanisms of injury, proper treatment can be ensured.

johncreynolds
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Elbow, Wrist, and Hand Injuries: Anatomy, Injuries, and Treatment

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  1. Chapter 20 The Elbow, Wrist, and Hand

  2. Objectives • Upon completion of this chapter, you should be able to: • Define the major components of the elbow • List major injuries and conditions of the elbow, wrist, and hand • List the different bones of the hand

  3. The Elbow, Wrist, and Hand • Many activities would be impossible without healthy functioning of the elbow, wrist, and hand • This area of the body is one of the most intricate, yet most vulnerable to injury

  4. Common Injuries of the Elbow • Contusions • Involve forearm muscles and subcutaneous bony prominences of the elbow • Direct blows can result in bruising, bleeding, and stiffness • Treatment: RICE and protective padding

  5. Common Injuries of the Elbow (cont’d.) • Olecranon bursitis • Inflammation of a bursa • Treatment: ice compresses, rest, and anti-inflammatory, pain medications, and occasionally aspiration of fluid

  6. Common Injuries of the Elbow (cont’d.) • Ulnar nerve contusion • Blow or contusion to ulnar nerve • Elbow strain • Acute or chronic • Acute occurs with sudden overload

  7. Common Injuries of the Elbow (cont’d.) • Epicondylitis • Chronic strains commonly occur in medial and lateral epicondyles • Caused by overload, faulty techniques, weak muscle groups, inappropriate equipment • Symptoms: local tenderness and resisted wrist motion causes pain • Treatment: prevention, appropriate equipment, limited stress, stretching, RICE, and activity modification

  8. Common Injuries of the Elbow (cont’d.) • Elbow sprains • Commonly result from forced hyperextension orvalgus/varus (side-to-side) forces • Symptoms: pain, a “pop”, tenderness, and swelling • Treatment: same as elbow strains • Dislocations of the elbow • Normally occurs as a result of a fall • Signs: obvious deformity, loss of function, and pain • Treatment: transport to medical facility

  9. Common Injuries of the Elbow (cont’d.) • Fractures of the elbow and forearm • Result of direct trauma, or indirect stresses transmitted through upper extremity • Symptoms: deformity, point tenderness, hemorrhaging, swelling, limited range of motion, disability, and pain • Treatment: immobilization, ice, elevation, and physician referral

  10. Common Injuries of the Elbow (cont’d.) • Volkmann’s contracture • Absence of blood flow (ischemia) to the forearm • Mild, moderate, or severe • Symptoms: pain, swelling, decreased sensation, weakness, and skin paleness

  11. Common Injuries of the Elbow (cont’d.) • Nerve injuries • Ulnar nerve • Symptoms: pain and tenderness • Radial nerve • Symptoms: pain and tenderness • Median nerve • Symptoms: pain, numbness and tingling

  12. Hand and Wrist Injuries • Fractures • Finger fractures • Boxer’s fracture • Baseball finger • Jersey finger • Scaphoid fracture • Colles’s fracture • Treatment: RICE, support, and medical evaluation

  13. Hand and Wrist Injuries (cont’d.) • Dislocations and subluxations • Dislocation: displacement of any bone from normal position • Subluxation: abnormal movement of a bone that constitute a joint • Symptoms: pain, swelling, and unable to bend or straighten • Treatment: ice, immobilization, and immediate consultation with a physician

  14. Hand and Wrist Injuries (cont’d.) • Contusions • Caused by direct blows or falling onto a hard surface • Sprains • Injury to a ligament • Gamekeeper’s thumb

  15. Hand and Wrist Injuries (cont’d.) • Tendonitis • Inflammation of tendons • Caused by overuse or repetitive stress • Symptoms: aching or pain at the wrist • Treatment: rest, ice, and anti-inflammatory medication

  16. Hand and Wrist Injuries (cont’d.) • Nerve impingement and carpel tunnel • Inflammatory disorder • Caused by repetitive stress, physical injury, or conditions that cause median nerve tissue swelling • Symptoms: pain, numbness, tingling, and weakness • Treatment: rest, ice, splinting or bracing, and sometimes surgical decompression

  17. Hand and Wrist Injuries (cont’d.) • Ganglion cyst of the wrist • Small, usually hard lump above a tendon or in the capsule that encloses a joint • Treatment: if painless, no treatment necessary

  18. Hand and Wrist Injuries (cont’d.) • Boutonnière deformity • Extensor tendon injury affecting proximal interphalangeal joint and distal interphalangeal joint • Symptoms: inability to flex and extend the finger, pain, and tenderness • Treatment: immediate medical attention

  19. Conclusion • The elbow, wrist, and hand contain some of the most intricate and complex joints in the body • Understanding the anatomy, biomechanics, and mechanisms of injury will ensure appropriate treatment • Elbow and forearm injuries are common • The elbow is prone to overuse injuries

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