Left Wrist Injury Report

A September 7 elbow fracture during the Double-A playoffs will cause minor league second baseman Ozzie Albies to miss the remainder of the playoff season with his team, the Mississippi Braves. The 19-year-old, who was expected to be one of the stars of the playoffs, had split his time this year between the Mississippi Braves and the franchise's Triple-A team, the Gwinnett Braves. Although Albies' injury will require surgery, he should be able to return to playing baseball by January.

Week 4 will bring us a Thursday Night Football game between AFC North rivals the Baltimore Ravens and the Pittsburgh Steelers. The Ravens have got off to a rocky start so far in 2015 with a 0-3 record, however, they’ll look to take advantage of a short-handed Steelers squad. Pittsburgh has had a solid start to their season, but they’ll be playing without longtime field general Ben Roethlisberger. This will be a pivotal game for Joe Flacco and the Ravens, so there should be some decent fantasy numbers coming from Baltimore.

This evidence based practice article explores the persistent concussive symptoms (symptoms lasting more than 90 days post-injury) in students from middle school, high school, and college that obtain many sport-related concussions. The studies by Harmon et al (2013) and Doolan, Day, Maerlender, Goforth & Brolinson (2012), found that just in the United states alone, there are over a million concussions every year and there are at least 50% of the concussions that are not reported. One that acquires a concussion will go through neurocognitive testing, see a physician, and go through screenings and more. Although these methods for management are being done to treat a concussion, there is not any evidence based practice to say that those methods are actually working. Therefore, the purpose of this study is to explore multiple treatment options, clinical rationale, and outcomes for each treatment. There were 24 cases a clients that were referred the Clinic at the University of Oregon for persistent concussive symptoms related to a sports injury. There were 14 women and 10

Cardiovascular Assessment: No visible pulsations, no heaves or lifts. Apical pulse present in the fifth intercostal space at the left midclavicular line. Auscultation of apical rate 62 beats per minute, normal rhythm regular S1 - S2 heart sounds present. Pulsations present when supine and disappear at a 45 degree angle position. Extremities are brown color without redness, cyanosis, lesions or varicosities bilaterally. Temperature warm bilaterally, Allen test was negative. Homan’s sign negative. Carotids: +2 and present bilaterally. Right Radial +2, left radial +1 , Right Brachial: +2

He also says and demonstrates that if he supports the wrist that the tip of the ulna "goes back in place" and if he holds it the pain goes away. He reports that he has a laxity in the wrist. The PA Ms. Becker went over the MRI, x-ray and the ultrasound. She said he was born with the ulna being longer, that it is not acute. The MRI did show some fluid which could be from inflammation. She said she would recommend he go to a hand specialist. Mr. Naranjo was not aware of the results of the MRI other than they were normal because he opted not to follow up with Dr. Branch. He said he did not like Dr. Branch, that he did not feel a connection. Ms. Becker would also recommend a MRI of the wrist done at Sparrow so the previous radiologist could compare it to the prior forearm MRI, She suggested Dr. Stevens a hand specialist, and she also ordered Occupational therapy to continue. Mr. Naranjo asked if she would order some pain medication since he has

O: Inspection of the right shoulder, no redness or edema noted; palpation of the right shoulder there was no warmth noted; on deep palpation TM reports in some tenderness

S: TM just finished working on a car in the back step off platform into pit, wielding AN Car, and fell back on pipes on his left lateral side. The initial pain was 10 out of 10 and it was difficult to breath related to pain. Now, he rates his pain at 5 to 6 out of 10, aching paint to his left shoulder and his left lateral rib cage. Denies any headache, blurred vision, N/V. Ice X 20 minutes now did helped him with symptoms management.

S: Aerotek TM is in HMMA Medical Clinic to follow up with Low Back strain with lumbar radicular pain that radiates down to back of his RIGHT HEEL. According to TM the incident occurred on 6/14/17. TM’s initial radicular pain was down to his left leg but now it is down to his right leg. According to TM for the past 6 weeks he hasn’t done nothing but raying around the house, and his back is not getting batter.

There is tenderness with motion of the wrist. Strength is 4/5. She is tender over the first dorsal extensor compartment and has a positive Finkelstein’s test. Assessment includes internal derangement of the right wrist, status post right wrist arthroscopy and De Quervain’s tendinitis of the right wrist/thumb. Patient will benefit from an additional course of PT to enhance and restore strength and function of her right wrist. She will benefit from a thumb spica splint to allow her tendinitis to resolve. She will continue applying her Voltaren gel.

Based on the progress report dated 02/29/16 by Dr. Naraghi, the patient reports worsening of her right lower extremity with pain, numbness and weakness.

Moreover, Tinel’s sign is positive bilaterally and Jamar grip strength is measured to be 10/10/10 bilaterally. Diagnoses include continuous trauma; cervical strain with radicular complaints; bilateral shoulder rotator cuff tendinitis with rotator cuff tear, status post left shoulder arthroscopy with rotator cuff repair; and bilateral wrist strain with carpal tunnel syndrome and degenerative arthritis of the index/long distal interphalangeal joint, triggering of the bilateral

Based on the medical report dated 01/06/17 by Dr. Shin, the patient reports that his left

Lenihan, the patient complains of popping sensation, stable with flexion/extension. IW reports pain on the medial side. Patient is wearing sleeve. Patient reports that at the end of the day, she has mild swelling on the elbow. She also reports numbness in the 5th finger and lateral side, increased with movement.

Based on the medical report dated 01/03/17, the patient presents for pain/dysfunction of the right wrist. IW states repetitive heavy lifting and complains of numbness, tinging and weakness.

O: Inspection of right elbow - No edema, discoloration, or swelling noted; tenderness with palpation near the lateral elbow when the wrist is bent forward; right hand Grip strength: Right +4, Left +5