BASIC DEFINITIONS

Strains: indirect injury to muscles and tendons caused by excessive stretch or tension within the fibers.
Grading system:

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• 1st degree - stretching & limited tearing of the fibers. Pain increases as the muscle contracts, especially against resistance, and the site of injury is point tender.�
• 2nd degree - actual tearing of some muscle fibers & results in bruising (ecchymosis).� Same, but more severe findings as 1st degree.�
• 3rd degree - complete rupture of the muscle, resulting in complete loss of function and a palpable defect in the muscle.� Pain, swelling, and ecchymosis are also present.

Sprains:� stretching or tearing of ligaments and/or joint capsule when the joint is stretched beyond its normal limits. �
Grading system:

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• 1st degree - little or no tearing of ligament fibers. � There is no abnormal motion produced when the joint is stressed.� Local pain, mild point tenderness, and slight swelling.�
• 2nd degree - partial tearing of the ligament's fibers, resulting in joint laxity (play) when the ligament is stressed.� Moderate pain and swelling with some loss of function.��
• 3rd degree - complete rupture of the ligament, causing gross joint instability. � Swelling is substantial; however, pain may be limited secondary to tearing of local nerve fibers.

Tendinitis:� "-itis" suffix indicates inflammation.� Therefore, this is an inflammation of a muscle tendon. � This type of injury typically occurs from small repetitive, overuse actions. � However, it can occur from a single traumatic episode.�

Bursitis:� There's that "-itis" suffix again.� This is an inflammation of what is known as a bursa (bursa sac). � Bursae (plural) are fluid-filled sacs that serve to cushion muscles, tendons, and ligaments from other friction-causing structures (bone, mainly) and to facilitate smooth movement.

Subluxation:� partial dissociation of a joint's articulating surfaces.

Dislocation:� complete dissociation of a joint's articulating surfaces.

Synovitis:� Another "-itis". � This is an inflammation of the capsule that surrounds a joint (like the knee or elbow) typically secondary to some other inflammation within or around the joint.

Fracture:� any "break" in the continuity of a bone.� Fractures and "broken bones" are the same thing. � There are bascially two classes of fractures with many types within each class. � The classes are closed (bone stays inside of the skin) and opened (bones sticks out of the skin).� Some of the different types of fractures are:

• displaced - a fracture in which the bones are no longer aligned,
• transverse - a fracture that is typically straight across the bone,
• greenstick - this fracture typically happens in children and looks like a broken "green" tree limb - kind of "stringy",
• hairline - very thin fracture that is hard to see on x-ray,
• incomplete - a fracture that is not completely through the bone,
• spiral - just like it sounds,
• comminuted - a fracture that looks like the bone exploded with many pieces throughout the fracture site, and
• avulsion - type of fracture where a ligament pulls off a piece of bone

RICE:� Rest, Ice, Compression, Elevation. � Typically you will want to ice the injury for 20 minutes, 3 times per day for the first 3 days.� DO NOT use HEAT of any kind on a new injury or if you see new swelling of an old injury.� You may use heat after the first 3 days, if the swelling as stopped. When in doubt - Use ice!!!

DIP:� this is the name of the last joint of your fingers - distal interphalangeal joint.

PIP:� this is the name of the first joint of your fingers - proximal interphalangeal joint.

MCP:� this is the name of the joint between your palm and your finger - metacarpophalageal joint.

Phalanx/phalanges:� these are your fingers

Metacarpals:� these are the bones of your palm.

Carpals:� these are your wrist bones - there are eight of them.

Collateral ligaments:� these are the ligaments on each side of a joint between bones.

MOI:� this is the abbreviation for "mechanism of injury" - meaning how the injury can occur.

ROM:� this means "range of motion"

Closed Reduction:� this is a procedure where the doctor/PA places the two fractured ends of bone in line with each other or places the two ends of a dislocated joint back into the proper position.� This is a non-surgical prodecure and sometimes requires the injection of a pain medication (e.g., lidocaine).

ORIF:� this stands for Open Reduction Internal Fixation.� This is a procedure where a doctor must surgically repair a fracture or dislocation normally with the use of pins, plates, and/or screws.

Abduction:� the movement of a body part away from its midline.

Adduction:� the movement of a body part toward its midline.

Proximal: the part of an extremity closest to the point of attachment.

Distal: the part of an extremity futherest away from the point of attachment.

Anatomical Snuff Box:the triangular depression observed on the back of the hand when the thumb is fully extended. It is bounded by the tendons of the extensor pollicis longus on the medial side and the tendon of the extensor pollicis brevis on the lateral side.�

Necrosis:death of cells, tissue, or organ. This can include, but is not limited to skin, muscle, & bone.

Median Nerve:this is the nerve that supplies the inside of your forearm and the thumb & index finger of your hand.

NSAIDs:Non-Steroidal Anti-inflammatory Drugs. This form of medication typically comes in pill form and is used to slow down the body's response to injury and give pain relief. Some of the more common NSAIDs are: Advil, Motrin, Midol IB (ibuprofen), Relafen (nabumetone), Aleve (naproxen), Celebrex (celecoxib), and Vioxx (rofexcoxib).