1. Chapter 14 – The Elbow and Forearm
Pages

2. Ligamentous Testing
Single-plane instability tested in frontal plane with elbow not fully extended
Full extension – olecranon is securely locked within fossa

3. Test for Medial Ligament Laxity
Anterior oblique portion of UCL
Primary restraint of medial elbow against valgus stress
Trauma = laxity throughout ROM
Injury to other ligaments unlikely without first damaging this structure
Valgus Stress Test – Box 14-3, page 508

4. Test for Lateral Ligament Laxity
Radial collateral ligament
Primary restraint against varus stress
Other involved ligaments that allow radius to separate from ulna
Annular L.
Accessory lateral collateral L. (ALCL)
Lateral ulnar collateral L. (LUCL)
Varus Stress Test, Box 14-4, page 509

5. Neurologic Testing
Nerve impingement occurring in shoulder or cervical region can result in disruption of motor and/or sensory function in elbow, forearm, hand
Nerve trauma at elbow refers symptoms to wrist, hand, fingers
Figure 14-18, page 507
Upper quarter screen, Box 1-6, page 17

6. Elbow Sprains Valgus or varus stress Rotational component
Blow or forceful motion to flexed elbow
Rotational component
Hyperextension mechanism
May stress anterior capsule or compress posterior structures

7. Ulnar Collateral Ligament
Valgus loading
Overhead pitching motion
Assistance from triceps, wrist flexor-pronator muscles, anconeus
LUCL may also be injured if force if sufficient
Evaluative Findings
Table 14-3, page 510

8. Ulnar Collateral Ligament
Posterolateral Rotational instability
Tears of LUCL permit rotatory subluxation of humeroulnar joint and subluxation of radiohumeral joint
Posterolateral Rotatory Instability Test
Box 14-5, page 510

9. Ulnar Collateral Ligament
Treatment
Alleviate repetitive forces
Reduce pain and inflammation
ROM
Strengthening
Assess ROM at shoulder
Excessive external rotation
Cocking and acceleration phases

10. Radial Collateral Ligament
Rare due to protection from body
Varus forces
Trauma to RCL, and possibly annular L.
May also disrupt articulation between radial head and capitellum
S & S similar to UCL sprain
Pain, laxity, weakness-pronation/supination
Treatment also similar to UCL sprain