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Care and Prevention Chapters 23 and 24

The Elbow, Forearm, Wrist, Hand, and Fingers

The forearm is comprised of the radius and ulna bones.
 
The elbow is a union of the humerus, radius, and ulna bones.
 
Its primary movements of the elbow are:  flexion, extension, and rotation (which takes place at the articulation of the humerus and radius)
 
The annular ligament holds the radial head in place at the junction.
 
Olecranon bursitis
MOI: usually results from direct blow
S&S: The inflamed bursa produces pain, sever swelling, and point tenderness.  Ocasionally, sweling will appear almost spontaneously and withouty the usual pain and heat.
Treatment: If the condition is acute, a cold compress ahould be aplied for at least one hour.  Chronic olecranon bursitis requires a program of superficial therapy primarily involving compression.  If swelling fails to resolve, in some cases aspiration will hasten healing.  Although seldom serious, olecranon bursitis can be anoying and should be well protected by padding while the athlete is engaged in competition.
 
Carpal Tunnel Syndrome
MOI: results from inflammation of the tendons and synovial sheaths within the space between the carpal bones and the transverse carpal ligament which ultimately leads to compression of the median nerve.  Carpal tunnel most often results in athletes who engage in activities that require repeated wrist flexion, although it can also result from direct trauma to the anterior aspect of the wrist.
S&S: Compression of the median nerve will usually result in both sensory and motor deficits.  Sensory changes could result in tingling, numbness, and paresthesia in the arc of median nerve innervation over the thumb, index and middle fingers and palm of the hand.  The median nerve innervates the lumbrical muscles of the index and middle fingers and the three of the thenar muscles.  Thus, weakness in thumb movement is associated with this condition.
Treatment: Initially, conservative treatmen involving rest, immobilization, and nonsteroidal anti-inflammatory medication is recommended.  If the syndrome persists, injection with a corticosteriod and possible surgical decompression of the transverse carpal ligament may be necessary.
 
 
Colles' Fracture involve the lower end of the radius or ulna.
MOI:  fall on the outstretched hand, forcing the radius and ulna backward and upward (hyperextension)
S&S:  In most cases, there is a forward displacement of the radius that causes a visible deformity to the wrist, which is commonly called a silver fork deformity.  Sometimes there is no deformity present, the injury is passed off as a bad sprain-to the detriment of the athlete.  Bleeding is profuse in this area, and the extravasated fluid can cause excessive swelling in the wrist and, if unchecked, in the fingers and forearm.
Treatment:  Apply a cold compress, splint the wrist, put the limb in a sling, and refer the athlete to a physician for xray and immobilization.  Barring complications, the Colles' fracture will keep an athlete out of sports for one or two months.
It should be noted that what appears to be a Colles' fracture in young children and youths is often a lower epiphyseal separation.
 
The eight (8) carpal bones are considered the wrist bones.  The radius and ulna also articulate at the wrist.
 
The carpal bones are:  navicular, lunate, triquetral, pisiform, trapezium, trapezoid, capitate, hamate.
 
Some Lovers Try Position That They Can't Handle
 
The navicular (scaphoid) bone is the most commonly injured carpal bone.  A fracture of this bone may not be apparent on xray until 10 days to 2 weeks after the injury.  Therefore, it's important to re-xray if there are any concerned.
 
The navicular (scaphoid) bone may be located by palpation of the distal radius in the anatomical snuffbox.
 
Primary wrist movements are:  flexion, extension, radial deviation (abduction), and ulnar deviation (adduction).
 
The forearm is a located between the elbow and the wrist.  Its bones are considered the radial and ulnar shafts.  Movements are pronation, and supination.