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Musculoskeletal Injury

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Musculoskeletal Injury, Soft Tissue Injury

  • Types
  • Soft Tissue Injury
  1. Ligament Sprain
    1. Injury to ligament or capsule
  2. Tendon Strain (Tendinopathy)
    1. Injury translated at musculotendinous junctions
  3. Contusion
    1. Blunt injury disrupts soft tissue (skin, muscle) capillaries and venules, resulting in Hemorrhage into local interstitial tissue
  4. Apophyseal Injury (children)
    1. Secondary ossification sites for tendon insertions, which may be injured with overuse prior to Growth Plate closure
    2. Examples
      1. Little Leaguer's Elbow
      2. Osgood-Schlatter Disease (knee)
      3. Sever's Disease (heel)
  • History
  1. Hand dominance (for upper extremity injuries)
  2. Profession or sports
  • Exam
  1. See Brief Musculoskeletal Exam
  2. See Neurologic Exam
  3. See Trauma Secondary Survey
  4. Approach: Every extremity injury
    1. Include examination of joint above and below the involved joint
    2. Include sensory, motor and vascular exam
    3. Include skin and compartment exam
    4. Mallon (2013) Shoulder Disorders, EM Bootcamp, Las Vegas
  5. Upper extremity
    1. Shoulder Exam
    2. Elbow Exam
    3. Hand Exam
    4. Wrist Exam
  6. Lower extremity
    1. Hip Exam
    2. Knee Exam
    3. Low Back Exam
  • Precautions
  • Assess for Fracture (Especially in children)
  1. Ligaments and Tendons are stronger than Growth Plate
  2. Bone Fractures less often after Growth Plate fusion