Describe the most imporant varus stabilizers at 0, 90 degrees
LCL, joint surface (primary) and capsule at 0 – at 90 degrees even more stability comes from the joint surface
Describe the most imporant varus and valgus stabilizers at 0, 90 degrees
MCL, joint surface, and anterior capsule are equal 0 – at 90 MCL is the primary
What is posterolateral rotatory instability?
typically occurs from FOOSH as the humerus goes into the IR which causes ER and valgus stress at the elbow
Which muscle is the primary elbow flexor?
What is little league elbow?
overuse injury including OCD of the capitellum with or without loose bodies, injury to the proximal radial epiphysis, overgrowth of the radial head
what is lateral epicondylitis?
tendonitis in the common extensor tendon but more likley disorganized collegen from micro tears which have failed to heal
What 5 tests are commonly used for radial tunnel syndrome
compression of the radial tunnel, long finger test, wrist ext, resisted supination, cuff test
Following a simple dislocation what would be expected on exam after relocation:
decreased ROM into ext and UE weakness, possible ligamentous instability that is more promient after acute symptoms resolve
Is immobilization recommended after simple dislocation of the elbow?
It may or may not be used – the longer the elbow is immobilized both intrinsic and extrinsic stiffnes increases and decreased healing of the articular cartilage, if the elbow is unstable at 45 degrees flexion then surgery is recommended
What are common concomitant injuries with simple elbow dislocation?
ligamentous instability, ulnar or median nerve injury, radial head fracture;
IF a patient is presenting with wrist extensor weakness which of the following would be the least likley Dx – lateral tendinosis, posterior interosseous nerve syndrome, posterolateral rotatory instability, radial tunnel syndrome
Radial tunnel syndrome because it is sensory only
Wainner test item cluster allows for what?
Detection of nerve root pathology
Best retest measure for lateral epicondylitis
A patient presents with increased cubitus valgus on the R greater than the L. The R elbow is warm to the touch at the medial condyle region with point tenderness in the flexor pronator mass. Tinel is negative. You suspect medial tendinosis with underlying ligamentous instability. What would be the most likely to be present
B) inadequate wrist ext with fingers extended
C) Negative milking manuver test
D) neural irritation of the radial nerve
B - patients with UCL instability are likely to present with medial tendinosisof the flexor pronator muscles including limitation in ROM and have TTP 2 cm distal to the medial epicondylitis; The milking maneuver tests for UCL instability
What techniques should be used to detect ulnar collateral ligament insufficiency?
Moving valgus stress test is the best; valgus stresss, milking, and AROM could be considered
What is the most appropriate Tx for ligamentous instbaility of the UCL?
Immobilization of the elbow with protected rest from aggravating activities including gymnastics