week 6 musculoskeletal trauma

treatment and management of rotator cuff tears

NSAIDs, rest, modification of activity, corticosteroid injection into joint, arthroscopic debridement, or acromioplasty with tendon repair

PRICE is a mnemonic used to treat contusions, strains, sprains and ligament injury, what does PRICE stand for?

P-protection R-Rest I-Ice C-compression E-elevation

treatment of contusions, strains, and sprains

PRICE, support or splint area, cold packs for 20 minutes at a time, elastic bandage compression to control bleeding and edema, elevation at or just above the heart, NSAIDs, monitor neurovascular status, if severe enough immobilization with cast or surgery

joint dislocation

a condition in which the articular surfaces of the distal and proximal bones that form the joint are no longer in proper alignment

why do contusions appear black and blue?

a hematoma develops from bleeding at the site of impact leaving a black and blue appearance

Contusion (bruise)

a soft tissue injury produced by blunt force, the injury causes small blood vessels to rupture and bleed into the soft tissues causing pain, swelling and discoloration

what is the difference between a strain and a sprain?

a strain involves the muscle or tendon of a body part that may have been over stretched or torn. a sprain involves injury to the ligament or tendon that surrounds a joint (I strained by back muscle, I sprained my ankle)

what are some possible causes of sprains?

a twisting motion or hyperextension of a joint

syme

above ankle amputation

AE

above elbow

AK

above knee amputation

symptoms of joint dislocation

acute pain, change in position of the joint, awkward position of the joint, and decreased range of motion

BE

below elbow

BK

below knee amputation

phantom limb pain

caused by severing of peripheral nerves, real pain, it may occur soon after injury and up to a year post amputation

first degree SPRAIN

caused by stretching the ligament fibers resulting in minimum damage, mild pain, local tenderness, edema

when should cold packs be applied to treat contusions, strains, sprains and ligament injury, and for how long?

cold packs are applied intermittently for no longer than 20 minutes for the first 24 to 72 hours

what are causes of joint dislocation?

congenital hip, pathologic (disease), and trauma

what does phantom pain feel like?

crushing, cramping, twisting pain that may be accompanied by numbness, tingling or burning sensation

gangrene

death of tissue associated with loss of blood supply

epicondylitis (tennis elbow or golfer's elbow)

excessive repetitive movements of the forearm that result in inflammation (tendonitis) and minor tears in the tendons which causes extreme tenderness and pain

wound care for a patient with an amputation

handle the stump gently, elastic pressure is applied to reduce edema, excessive edema can develop in a short time, limb should not be elevated with a pillow, encourage prone position to stretch flexor muscles and prevent flexor contractures of the hip, aseptic technique,

when should a joint dislocation be treated?

immediately because joint dislocation causes trauma to nerves and blood vessels which may lead to avascular necrosis (AVN) which will cause the bone to die

sprain

injury to ligaments and tendons that surround a joint

Acromioplasty

is an arthroscopic surgical procedure of the acromion. Generally, it implies removal of a small piece of the surface of the bone (acromion) that is in contact with a tendon causing, by friction, damage to the tendon.

strain

may be called a pulled muscle or tendon, it can be caused by overuse, overstretching or excessive stress, person may experience pain, local tenderness, edema, muscle spasm, bruising or loss of function

why should an amputated limb not be elevated with a pillow?

may result in flexion contracture of the hip

first degree strain

mild stretching of the muscle or tendon with no loss of ROM, palpation induced tenderness and mild muscle spasm

second degree strain

moderate stretching or partial tearing of a muscle or tendon, acute pain and tenderness at site with increased pain with passive range of motion, swelling bruising, and significant muscle spasm

third degree sprain

occurs when a ligament is completely torn or ruptured, may exhibit severe pain, increased edema, and abnormal joint motion

second degree sprain

partial tearing of the ligament, increased edema, tenderness, pain with motion, joint instability, and partial loss of normal joint function

indications for amputation

peripheral vascular disease, gangrene, trauma, congenital deformities, chronic osteomyelitis, cancer, relief of pain, improve function, improve quality of life

what position helps prevent flexion contractures of the hip and stretches the flexor muscles?

prone position

Treatment of epicondylitis

rest, ice, NSAIDs, immoblization, corticosteroid injection, wearing a counterforce strap to the forearm which applies pressure just below the elbow pain to prevent pulling on pain location

rotator cuff tears

rip in a tendon that connects one of the rotator muscles to the humeral head from stress on joint (acute or chronic), pain with lifting, dull aching pain, limited movement, decreased strength and difficulty sleeping on the affected side

third degree strain

severe muscle or tendon stretching with rupturing and tearing of the involved tissue with significant pain, muscle spasm, bruising, edema, and loss of function

how long may sprains and strains take to heal?

weeks to months