Upper Extremity Injuries

Upper Extremity Injuries

1. AC Sprain

• Mechanism: Fall on an outstretched arm, direct blow to the shoulder.

• Special Tests: Cross-body adduction test, AC joint compression test.

• Signs/Symptoms: Pain at the AC joint, swelling, tenderness, limited shoulder motion.

• Treatment: Rest, ice, anti-inflammatory medications, physical therapy, possible surgical intervention for severe cases.

2. SC Sprain

• Mechanism: Direct trauma to the shoulder, fall, or forceful impact.

• Special Tests: Sternoclavicular joint stability test.

• Signs/Symptoms: Pain and swelling at the SC joint, possible displacement.

• Treatment: Rest, ice, immobilization, physical therapy.

3. Clavicle Fracture

• Mechanism: Fall on the shoulder, direct impact.

• Special Tests: Inspection for deformity, palpation of clavicle.

• Signs/Symptoms: Pain, swelling, deformity, difficulty lifting arm.

• Treatment: Sling immobilization, surgery for displaced fractures.

4. Glenohumeral Dislocation

• Mechanism: Arm is forced into an awkward position, often seen in sports.

• Special Tests: Apprehension test, relocation test.

• Signs/Symptoms: Visible deformity, intense pain, inability to move arm.

• Treatment: Reduction (relocation), immobilization, physical therapy.

5. Glenohumeral Subluxation

• Mechanism: Repetitive overhead activities, trauma.

• Special Tests: Apprehension test.

• Signs/Symptoms: Feeling of the shoulder "slipping," pain, instability.

• Treatment: Strengthening exercises, physical therapy, possible surgical intervention.

6. Rotator Cuff Strain

• Mechanism: Overuse, acute injury.

• Special Tests: Drop arm test, empty can test.

• Signs/Symptoms: Pain, weakness in shoulder, limited range of motion.

• Treatment: Rest, ice, physical therapy, corticosteroid injections.

7. Impingement in the Subacromial Space

• Mechanism: Repetitive overhead activity, structural abnormalities.

• Special Tests: Neer test, Hawkins-Kennedy test.

• Signs/Symptoms: Pain during overhead activities, tenderness in the shoulder.

• Treatment: Rest, physical therapy, corticosteroid injections, possible surgery.

8. Slap Tear

• Mechanism: Overhead activities, falling on an outstretched arm.

• Special Tests: O'Brien's test, biceps load test.

• Signs/Symptoms: Pain with overhead motions, clicking or popping sensation.

• Treatment: Rest, physical therapy, surgery for severe cases.

9. Bankart Lesion

• Mechanism: Shoulder dislocation, typically anterior.

• Special Tests: Apprehension test.

• Signs/Symptoms: Shoulder instability, pain, weakness.

• Treatment: Rehabilitation, surgery if conservative treatment fails.

10. Bicep Tendinitis

• Mechanism: Overuse, repetitive overhead movements.

• Special Tests: Speed's test, Yergason's test.

• Signs/Symptoms: Pain in the front of the shoulder, tenderness.

• Treatment: Rest, ice, physical therapy, anti-inflammatory medications.

11. Lateral Epicondylitis

• Mechanism: Overuse of wrist extensors, often seen in racquet sports.

• Special Tests: Cozen's test, Mill's test.

• Signs/Symptoms: Pain on the outside of the elbow, weakness in grip.

• Treatment: Rest, ice, physical therapy, brace, corticosteroids.

12. Medial Epicondylitis

• Mechanism: Overuse of wrist flexors, common in golfers.

• Special Tests: Golfer's elbow test.

• Signs/Symptoms: Pain on the inside of the elbow, weakness in grip.

• Treatment: Rest, ice, physical therapy, brace, corticosteroids.

13. UCL Sprain (Elbow)

• Mechanism: Overhead throwing, repetitive stress.

• Special Tests: Valgus stress test.

• Signs/Symptoms: Pain on the inside of the elbow, instability.

• Treatment: Rest, physical therapy, possible surgery (Tommy John surgery).

14. RCL Sprain (Elbow)

• Mechanism: Varus stress on the elbow.

• Special Tests: Varus stress test.

• Signs/Symptoms: Pain on the outside of the elbow, swelling.

• Treatment: Rest, ice, physical therapy.

15. Ulnar Nerve Contusion

• Mechanism: Direct trauma to the elbow, falling.

• Special Tests: Tinel's sign.

• Signs/Symptoms: Tingling or numbness in the pinky or ring finger.

• Treatment: Rest, ice, and physical therapy.

16. UCL/RCL Sprain (Wrist)

• Mechanism: Forced motion or impact.

• Special Tests: Valgus/varus stress tests.

• Signs/Symptoms: Pain, swelling, instability.

• Treatment: Rest, immobilization, physical therapy.

17. Scaphoid Fracture (Anatomical Snuffbox)

• Mechanism: Fall on an outstretched hand.

• Special Tests: Palpation of scaphoid in anatomical snuffbox.

• Signs/Symptoms: Wrist pain, swelling, tenderness in the snuffbox.

• Treatment: Immobilization in a cast, surgery if displaced.

18. Metacarpal Fracture (Including Boxer's Fracture)

• Mechanism: Punching an object, direct trauma.

• Special Tests: Palpation of metacarpal bones.

• Signs/Symptoms: Pain, swelling, possible deformity.

• Treatment: Casting, surgery for severe cases.

19. Phalange Fracture

• Mechanism: Trauma, crush injury, or sports injury.

• Special Tests: Range of motion tests.

• Signs/Symptoms: Pain, swelling, deformity.

• Treatment: Splinting, casting, surgery if needed.

20. Phalange Dislocation

• Mechanism: Trauma or fall.

• Special Tests: Assessment of range of motion.

• Signs/Symptoms: Deformity, swelling, intense pain.

• Treatment: Reduction, splinting, possible surgery.

21. Game Keeper's Thumb

• Mechanism: Trauma to the thumb, often from a fall or sports.

• Special Tests: UCL stress test.

• Signs/Symptoms: Pain and swelling at the base of the thumb.

• Treatment: Splinting, rest, possible surgery for severe cases.

22. Carpal Tunnel

• Mechanism: Repetitive wrist motions, swelling, or direct compression.

• Special Tests: Phalen's test, Tinel's sign.

• Signs/Symptoms: Tingling, numbness in the thumb, index, and middle fingers.

• Treatment: Rest, splinting, corticosteroids, surgery if severe.

23. Elbow Dislocation

• Mechanism: Fall on outstretched arm, direct impact.

• Special Tests: Neurovascular assessment.

• Signs/Symptoms: Deformity, pain, swelling, inability to move elbow.

• Treatment: Reduction, immobilization, physical therapy.

24. De Quervain's Tenosynovitis

• Mechanism: Overuse of thumb tendons.

• Special Tests: Finkelstein's test.

• Signs/Symptoms: Pain on the radial side of the wrist, swelling.

• Treatment: Rest, ice, splinting, corticosteroid injections.

25. Carpometacarpal Arthritis

• Mechanism: Wear and tear over time.

• Special Tests: CMC grind test.

• Signs/Symptoms: Pain at the base of the thumb, swelling, stiffness.

• Treatment: Splinting, physical therapy, corticosteroids, surgery for severe cases.

26. Bicep Tear

• Mechanism: Sudden heavy lifting or trauma.

• Special Tests: Bicep's squeeze test.

• Signs/Symptoms: Sudden pain in the upper arm, visible deformity.

• Treatment: Rest, ice, physical therapy, surgery if necessary.

27. Colles Fracture - Distal Radius and Ulna

• Mechanism: Fracture and displaced posteriorly from a fall on an outstretched hand.

• Special Tests: Palpation of distal radius.

• Signs/Symptoms: "Dinner fork" deformity, swelling, pain.

• Treatment: Casting, possible surgery for severe displacement.