Exam & Diagnosis Exam #1 (Injuries)

antalgic gait
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Terms in this set (51)
FOOSH/FOOSAfall on outstretched hand/armcommon FOOSH/FOOSA injuries-colle's fracture -smith fracture -scaphoid fractureColle's Fracturefracture of the distal radius and ulna with DORSAL displacement of the distal segment MOI- fall on outstretched arm, wrist extended AKA- dinner fork deformitySmith fracturefracture of the distal radius and ulna with VENTRAL displacement of the distal segment MOI- fall on outstretched arm, wrist flexedscaphoid fracturemost fractured bone in the wrist MOI- most commonly a fall on outstretched hand complications- difficult to confirm with x-ray, poor blood supply to scaphoid results in poor healingBennett's fracturefracture of the base of the first metacarpal due to axial loading MOI- direct blow to the thumb with fistphalanx fracture"jammed" joint surface fracture (axial load) MOI- direct blow or rotational force *if rotational force causes a dislocation, also suspect a fracturefinger dislocationsPIP is most common (varus, valgus or hyperextension) MP dislocation is more significantthumb dislocationvery significant *might try to avoid reducingopen dislocationsinvolve bone showing through skin similar to an open fracture *are considered an emergencylunate dislocationmost common carpal dislocation MOI- FOOSH/A ventral (or palmar) dislocation is serious, potential damage to median nerve *often confused with ganglion cystwrist sprains-can be complicated due to complex ligamentous structure -one or many instabilities between carpals can result from acute or chronic hypermobilityfinger sprainscan affect collateral ligaments stabilizing the IP joints can cause damage to capsule at IP joints MOI- varus, valgus or hyperextension *collateral ligament can be avulsedthumb UCL sprainsMOI- abduction and/or hyperextension 3rd degree- gamekeeper's thumb -severe laxity -chronic instability & dysfunction -early arthritis *common skiing injuryjersey fingeravulsion of the flexor digitorum profundus FDP is below the flexor digitorum superficialis, goes all the way to base of distal phalanx during avulsion, portion of distal phalanx is pulled off by tendon FORCED EXTENSION WHY FINGER IS ACTIVELY FLEXEDmallet fingeravulsion of the extensor digitorum FORCED FLEXION WHEN FINGER IS ACTIVELY EXTENDED *be careful not to confuse with cuticle infections/inflammationboutonniere deformityrupture of the central slip of the extensor digitorum tendon MOI- forced flexion of the PIP joint changes biomechanics *technically there is no rupture or avulsion but affects tendon mechanicsswan neck deformitydistal detachment of volar plate (anterior capsule ligament) PIP in slight extension and DIP appears partially flexedtrigger fingertenosynovitis of the flexor tendons results from repetitive trauma to flexor tendon sheaths, thickening or nodules develop in the tendinous sheathDe Quervain's Disease*chronic injury tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons results from repetitive gripping ulnar deviationcarpal tunnel syndromecompression of the median nerve by palmar carpal ligament causes- overuse, bony protrusion into the tunnel, fluid retention S&S- pain, tenderness over palmar wrist, sensory changes (numbness, tingling, paresthesia) and motor weaknessDupuytren's contractureflexion contracture of the MCP and PIP joints from contracture of palmar fascia *common deformity seen in older adultspisiform fracturefracture of pisiform MOI- FOOSHflexor carpi ulnaris tendonitispisiform fractures can cause pain and adverse effects leading to injury of FCUTFCC tearsdiminishes movement between ulna/radius and proximal carpals MOI- FOOSH, direct blow to ulnar side of wrist, swinging a bat or racquet, violent twist of the wrist S&S- pain on ulnar side of wrist, clicking, catching, weakness, instability, movement laxity arthroscopy might be necessary to diagnoseUCL sprains3 bands (triangular ligament) single ligament, three different orientations *stress testing performed in different positions *prevents valgus & hyperextension S&S- paresthesia in 4th and 5th fingers, inability to extend elbow, laxity"Panner's Disease"osteochondritis dissicans defects of chips in articular surfaces between radial head and capitulum -medial structures stretched, lateral structures condensed MOI- valgus forces during throwing, late cocking Usually requires surgical removal of loose bodiesepicondylitis (medial)"little league elbow" -wrist flexors can be injured on follow through -curve balls, types of pitches and number of pitches can impact likelihood of injury occurrenceepicondylitis (lateral)"tennis elbow" -backhanded motion -flexed wrist forward motion as well (lots of stress on lateral structures, compression of medial structures)epicondylitis in youthavulsed epicondylar growth plates x-rays if necessaryacute bursitisdirect blow to bursa -bursa inflates, fills with fluid, bubbles up (not recommended to participate with bursitis) -allow for bursa to recoverulnar nerve contusiondirect blow to elbow that contuses ulnar nerve -numbness and tingling in 4th and 5th digit -ulnar nerve "bruising"supracondylar fracturestypically caused by hyperextension (FOOSA) complications- compartment syndrome and volkmann's contracturecompartment syndromecaused by swelling or fluid build up, causing pressure that constricts or compresses other structures, limiting or impairing function -numbness & tingling etc.Volkmann's contracturecellular ischemia to forearm musculature -inadequate blood supply to forearm muscles, resulting in shortening of muscles (permanent flexion of fingers and wrist) -common with stroke or heart attackAnterior shoulder instabilityMOI- external force causing abduction, horizontal extension & external rotation OR direct blow to posterior shoulder *sulcus may be a visible indicator -anterior dislocation (cunningham technique to reduce) -fracture of glenoid or humerus -tear of GH ligaments -stretch or tear of RCHill Sachs Lesiondefect of compression fracture to posterior aspect of humeral headBankart Lesiontear in anterior capsule likely involving the labrum -part of capsule is generally stretched in a certain directionposterior shoulder instabilityMOI- FOOSA, elbow flexed to 90 degrees and internally rotated OR direct blow to anterior shoulder *reverse Hill Sachs lesion -fracture to glenoid or humerus -posterior tear of joint capsule -stretch or tear of RCmultidirectional shoulder instabilityMOI- usually no direct incidence or several instances of unspecific "shifting" *check for hypermobility -usually no labrum involvement, extremely loose structuresSLAP lesionsuperior labrum anterior to posterior -labral tear, positive avulsed biceps tendon -anterior to posterior, detaches from the glenoid -attachment of biceps tendon is superior labrum *O'Brian's test, Clunk test, Speed's test