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case study on scaphoid fracture
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Objective: To describe the evaluation, diagnosis, and progressive treatment for a student who sustained a scaphoid fracture while mountain biking.
Background: Scaphoid fractures are often difficult to diagnosis due to the inconsistency of symptoms compared to other types of fractures. Moreover, additional radiographic imaging may be necessary to identify a scaphoid fracture.
Treatment: Immobilization of the wrist followed by rehabilitation for structural integrity, pain-free range of motion, and muscular strengthening for the forearm and wrist muscles.
Differential Diagnosis: Muscle strain, wrist sprain, scaphoid dislocation, arthritis, De Quervain’s syndrome.
Conclusion: Scaphoid fracture are a common sports injury, and the most common carpal fracture in the wrist. Scaphoid fractures often are left undiagnosed or misdiagnosed due to the lack of signs and symptoms typically present with a bone fracture. Due to this, referral for x-rays or MRIs is important for a proper diagnosis and rehabilitation plan.
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The scaphoid is one of the eight carpal bones in the wrist. It is bordered distally by the triquetrum, trapezoid and capitate, medially by the lunate, and proximally by the styloid process of the radius. It can be found by palpating the anatomical snuffbox on the hand, or the area on the lateral wrist formed by the extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus, and styloid process of the radius.
Case Report
On September 18th, a 20-year-old male NMU ROTC student presented to the clinic with pain in his right wrist. The patient reported no previous injury to his right wrist or right arm. The onset of injury occurred a month early in late August, and the mechanism of injury was falling on his outstretched hand on to a stationary rock while mountain biking. During the evaluation, the patient reported a dull, achy pain with a four out of ten at rest on the pain scale and an eight out of ten in use. The patient also reported a sharp pain when performing activates, such as push-ups, twisting a doorknob and shaking hands. An objective assessment of the patient’s right wrist revealed mild swelling and abrasion over the right thenar eminence. Point tenderness was reported over the right scaphoid, trapezoid, capitate, and lunate along with the thenar eminence. Range of motion tests where diminished for active movements for all wrist motions, especially with radial deviation, and only extension improved with passive movements. Pain was present with all movements.
Special tests performed did not initially indicate a fracture in the wrist.
The origin of the triceps brachii is also from the scapula like the biceps brachii. In a mink, the extensor digitorium originates on the lateral epicondyle of the humerus yet in humans it is present in the posterior forearm and is responsible for extending the phalanges, wrist, and elbow in both species. Anothier muscle with similar functions to the extensor digitorium is the flexor carpi ulnaris but instead it is soley responsible for flexin... ... middle of paper ... ...
That's basically it. A surgery that baseball players and fans have grown to appreciate, and one of the more scientific breakthroughs in modern sports medicine. And after doing this report I’m fascinated by the modern science and how a tendon in your wrist can be used as a ligament.
Intra articular fractures of calcaneus occurs following eccentric loading of the talus on the calcaneus.(fig 5.1) The severity, type and location of fracture are determined by the position of the foot, the direction and magnitude of applied force and quality of bone 49.
The all too familiar "pop!" immediately followed by weakness, pain, and immobility; the classic signs of a shoulder injury. Many shoulder injuries affect the rotator cuff. "Each year approximately 200,000 American require surgery related to the repair of the rotator cuff" (Yamaguchi). This vast number of surgeries makes shoulder injuries a popular topic in the medical field. Physicians have been researching ways to improve patients' recovery and return their range of motion back to normal. One such improvement is the release of the long head of the biceps tendon.
When comparing rotator cuff tears from the common people and athletes, they are much more common when a person is physically active in sports. An injury in the rotator ...
Duff, John F. Youth Sports Injuries. A Medical Handbook for Parents and Coaches. New York: MacMillan, 1992. (pp.
All injuries are a serious matter, but upper body injuries are more delicate. “Although the majority of contusions to the most parts of the body result injuries that are self-correcting and without serious consequence, even relatively
A hypothesis that can be made from the patient’s report is that she is suffering from cervical radiculopathy, or a nerve root lesion. Symptoms that describe cervical radiculopathy include: arm pain in a dermatome distribution, pain increased by extension, rotation, and/or side flexion, possible relief of pain from arm positioned overhead, affected sensation, altered hand function, no spasticity, and no change to gait or bowel and bladder function (Magee, 2008, p. 142). These symptoms correlate to what the patient reported as a result of her injury. She stated that her pain is in the posterolateral upper and lower arm with aching and paresthesia in the thumb and index finger, which is in the dermatome pattern of cervical root 5 and 6 (C5, C6) (Magee, 2008, p. 25). She also reports lancinating pain with extension or rotation to the right of her head.
While not many acute injuries, or injuries that are associated with a traumatic event can be prevented, nearly all overuse injuries can be! Nevertheless, sports medicine physicians receive training to treat any kind of injury; acute, chronic, overuses or even psychogenic pain. Sports medicine dates back to Susruta of India who was the first “recorded” physician to prescribe moderate daily exercise around 600 B.C. (Tipton). Since then, professionals have redesigned and renovated the techniques and equipment used in this field. Sports medicine physicians go through years of education and training in order to effectively treat and interact with patients, as well as thrive in any workplace they are needed.
attention. The Athletic Trainer will tell you to get the injury checked out by going to the hospital and
These types of injuries could take upwards to eighteen months to return to playing condition, and in this time an athlete will often fall behind in the sport that they love. This often causes the athlete to quit the sport they once loved because they can no longer truly compete amongst their peers. I know that there has to be a way to accelerate this process of recovery and get those athletes back on the field. This is where my passion for orthopaedics
People have created a hectic and busy world, that includes careers and daily activities that require physical activity. While attempting to attain the required physical conditioning, people often take chances with their personal health as they try to stretch their physical limits. Sometimes, people can surpass their current limits and form new boundaries; however, other times people are not so fortunate. These unfortunate times often lead to injury, including workplace accidents, sporting incidents, disease afflictions, as well as others; any or all of which could bring about the need of rehabilitation services. Many of these require physical therapy, which includes assisting injured or otherwise impaired patients as they recover to their pre-injury status or to recover as much as is physically possible. The field of physical therapy is a choice career for those who enjoy helping people recover from injury, and the following text will provide reason for choosing this profession.
Patient returned the next day still complaining of pain. The PT applied heat, then initiated the exercise program, but the patient could not perform theem to same extent as previously, secondary to pain. Therefore, the PT told the patient to schedule an appointment with his physician. The patient was seen by the MD the next day and an arthrogram performed that revealed a reinjure to the repaired site. And a second surgery repaired the rotator cuff.
By having physiotherapy this will help to achieve and restore movement and function to the injured area of the body. To allow movement and function to occur an individual would complete a range of different exercise which, their therapist will show them how to do. This overall, would improve the ranges of movements and by improving the movements overall, it will help to heal the injured area so that, an individual would be able to do normal movements once again. Also, by attending physiotherapy it will reduce the chance of experiencing long-term injuries occurring like this happening again within a certain area of the
An ankle fracture is a break in one or more of the three bones that make up the ankle joint. The ankle joint is made up by the lower (distal) sections of your lower leg bones (tibia and fibula) along with a bone in your foot (talus). Depending on how bad the break is and if more than one ankle joint bone is broken, a cast or splint is used to protect and keep your injured bone from moving while it heals. Sometimes, surgery is required to help the fracture heal properly.