Session #4: Injuries of the Upper Extremities

Original Release Date: November 29, 2021

This session explored upper extremity injuries, including the shoulder, elbow, wrist, and hand. Participants learned about a range of common diagnoses, including arthritis, Carpal Tunnel Syndrome, fractures and ligament injuries, Med/Lat Epicondylitis (Tennis Elbow), treatment options, and how to overcome rehabilitation obstacles and challenges to best support the workers’ recovery.

Watch the webinar to learn:

00:00 Introduction

1:48 Welcome to the Injury Insight Series

3:10 Session Speaker

4:13 Outline

4:50 Hand Problems Can Drive People Crazy

5:19 Catastrophization

5:56 Hand Posturing is a Nonverbal Indicator od Catastrophic

6:37 Steroid injections: fact vs myth

9:30 Complications of Steroid Injection: depigmentation

9:47 Depigmentation: Prevention

10:25 Distal Biceps Rupture

10:30 Distal Biceps Rupture: Who Gets it?

11:01 Distal Biceps Rupture in Action

11:43 Distal Biceps Anatomy

12:59 H&P

13:56 MRI: Usually Not Necessary

14:59 Distal Biceps Rupture

16:00 Distal Biceps Fixation

17:08 Rehab

19:12 Lateral Epicondylistis. What is it?

19:49 Anatomy

20:36 Pathology: Tendinosis

20:50 Who Gets it?

21:24 Risk Factors for LE

21:22 If No Inflammation, Why Does it Hurt?

22:36 Diagnosis: Clinical

23:00 Imaging

24:30 Natural History

25:02 Treatment

25:28 Treatment: Contradictory Approaches

26:22 Straps, NSAIDs, Iontophoresis, Ultrasound, Therapy

27:33 RCT: 185 pts, 3 Groups Over 6 Weeks

29:00 Double-blind RCT for Lateral Epicondylitis: PRP vs Corticosteroids

29:43 Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline

30:20 Other Injectables

31:11 Indications for Surgery

31:45 Surgical Options

33:58 Surgery Results

34:53 ARS Question

36:24 Ulnar Nerve Anatomy

37:27 Anatomy – Innervations

37:46 Symptoms of Ulnar Nerve Compression

39:08 Physical Examination

39:36 How Good are These Tests?

40:45 What is the Underlying Pathology?

41:07 Should We Get Nerve Studies Before Operating

41:42 Nerve Conduction Studies

42:39 Diagnosis: Ancillary Studies

43:13 McGowan Classification

44:00 Nonoperative Treatment

44:33 Surgical Treatment

45:18 Results: Meta – Analyses

46:04 Outcomes

46:57 ARS Question

49:11 Carpal Tunnel Syndrome

50:23 CTS Symptoms

52:07 Who Gets CTS?

52:35 Tinel’s Sign

52:54 Phalen’s Sign

53:04 Durkan’s Sign

53:26 When to Get Nerve Studies? 53:43 Diagnostics: CTS

53:57 CTS Treatment

54:21 What About Typing: Controversial

54:44 Steroid Injections

55:07 Ergonomic Modifications

55:19 When to Operate?

55:33 ARS Question

56:25 CTR: Postop Narcotic Consumption

57:30 Q&A Section

1:02:55 Conclusion