Elbow Instability - Callum Clark 14/11/2002

Clinical Examination

NB: Do varus and valgus at 20 " 30 degrees of flexion, to unlock the bones.

Valgus is done with forearm pronated, to prevent confusion with PLRI

Posterolateral rotatory instability

The lateral pivot-shift test of the elbow.

With the patient in the supine position and the affected extremity overhead, the wrist and elbow are grasped as the ankle and knee are held when examining the leg.

The elbow is supinated with a mild force at the wrist and a valgus moment is applied to the elbow during flexion.

This action results in a typical apprehension response with reproduction of the patient's symptoms and a sense that the elbow is about to dislocate.

The radial head should then reduce as you flex to beyond about 40 degrees.

Anatomy

Medial Ligaments

·          3 parts (functions determined by cutting studies):

o         Anterior bujdle " tight in extension