Injury Nomenclature

1
Chapter 2

• Injury Nomenclature

2
Soft Tissue Injuries

• Most common form of orthopedic trauma
• Injuries to
• Muscles, Tendons, Skin, Joint Capsules,
  Ligaments, Bursae
• Affect Performance by
• Hindering joint motion
• Decreasing ability of muscle to produce force
• Creating joint instability
• Limiting amount of motion available to joint

3
Musculotendinous Injuries

• Affects muscles ability to contract fully,
  forcibly, or both
• Mechanical insufficiency vs. pain
• Partial tear in muscle or tendon
• Decreased force production secondary to pain
  elicited during contraction
• Complete tear
• Inability to produce any force

4
Strains

• Tensile Forces
• Dynamic Overload
• Three-degree grading scale
• First-degree strains
• Second-degree strains
• Third-degree strains
• Table 2-1, page 31

5
Tendinitis

• Table 2-2, page 31
• Tenosynovitis
• Peritendinitis
• Three-degree grading scale
• Partial or complete tendon tearing
• Calcific tendinitis
• Table 2-3, page 32

6
Myositis Ossificans

• Figure 2-2, page 32
• Formation of bone within a muscle bellys fascia
• Due to traumatic injury
• Very important to differentiate between muscle
  strain and contusions versus the formation of
  ossification
• Table 2-4, page 33

7
Bursitis

• Bursae fluid-filled sacs that serve to buffer
  muscles, tendons, and ligaments from
  friction-causing structures and facilitate smooth
  motion
• Table 2-5, page 34

8
Joint Structure Injuries

• Injuries involve the capsular and ligamentous
  tissues
• Directly affect the joints stability

9
Sprains

• Occur when joint is forced beyond its normal
  limits resulting in stretching or tearing of
  ligaments, joint capsule, or both
• Three-degree grading scale
• Table 2-6, page 35

10
Joint Subluxation

• Partial or complete disassociation of the joints
  articulating surfaces
• Subsequent episodes
• Apprehension Response
• Table 2-7, page 35

11
Joint Dislocation

• Obvious deformity, Figures 2-3 and 2-4, page 36
• Risk of injury to bony, vascular, neurological,
  and other soft tissue structures
• Dislocation of major joint medical emergency
• Table 2-8, page 36

12
Synovitis

• Table 2-9, page 37

13
Articular Surface Injuries

• Articular or hyaline cartilage may be injured
  acutely or damaged as a result of degenerative
  changes
• Irreversible, leads to chronic pain and/or
  dysfunction

14
Osteochondral Defects

• Fractures of a bones articular cartilage and
  progressive softening of the cartilage
• Severity based on depth of defect and location
• Table 2-10, page 38

15
Osteochondritis Dissecans

• Dislodged fragments of bone within the joint
  space
• Talus, femur, patella, capitellum, and humeral
  head most frequently affected
• Pain, loss of ROM, decreased joint function,
  locking
• Table 2-11, page 39

16
Arthritis

• Osteoarthritis degeneration of joints
  articular surface
• Weight-bearing joints
• Regeneration causes bony outgrowths
• Figure 2-8, page 40
• Rheumatoid Arthritis systemic condition
• Table 2-12, page 40

17
Bony Injuries

• Tend to be traumatic
• Proper initial management
• Pediatric and adolescent population

18
Exostosis

• Wolffs Law
• Growth of extraneous bone
• Figure 2-9, page 41
• Table 2-13, page 41

19
Apophysitis

• Growing pains inflammation of bone growth
  plate
• Figure 2-10, page 42
• Attachment sites for strong muscle groups
• Rapid growth spurt, lack of flexibility

20
Fractures

• Classified based on
• Location of fracture, Box 2-1, page 43
• Magnitude of fracture line, Box 2-2, page 43
• Shape/direction of fracture, Box 2-3, page 44

21
Avulsion Fractures

• Tearing of ligament or tendon from bony
  attachment
• Small vs. large tendons
• Figure 2-11, page 42

22
Stress Fractures

• Chronic condition (repetitive stress), most
  common in lower extremity
• Changes in training, equipment, surfaces
• Table 2-14, page 45

23
Neurovascular Pathologies

• Nerves, arteries, veins
• Due to joint dislocation, bony displacement,
  concussive forces
• Injury can lead to loss of function
• If untreated, vascular injury can lead to loss of
  body part

24
Peripheral Nerve Injury

• Entrapment injuries are common at ankle, elbow,
  wrist, cervical spine
• More distal greater probability of regeneration
• Swelling can cause paresthesia and muscular
  weakness
• Stretch injuries
• Neurapraxia
• Axonotmesis
• Neurotmesis

25
Complex Regional Pain Syndrome(Reflex
Sympathetic Dystrophy)

• Exaggerated, generalized pain response after
  injury
• Intense, prolonged pain that is out of proportion
  to severity of injury
• Prognosis is variable
• Symptomatic relief

26
Imaging Techniques

• Table 2-15, page 47
• Various figures, pages 47-50