Examination of Pediatric Elbow
Nirmal Raj Gopinathan in Clinical Orthopedic Examination of a Child, 2021
The lateral collateral ligament (Figure 6.2) includes three parts, namely the annular ligament, lateral ulnar collateral ligament, and radial collateral ligament. It provides posterolateral rotational stability and protects against varus stress on the elbow.5The lateral ulnar collateral ligament is the major stabilizer extending from the humeral lateral epicondyle to the supinator crest on the ulna.The radial collateral ligament originates from the lateral humeral epicondyle and inserts on the annular ligament.The annular ligament has its origin and insertion at the sigmoid notch of the ulna and it wraps around the radial neck. It stabilizes the proximal radioulnar joint.The accessory lateral collateral ligament begins at the annular ligament and inserts at the supinator crest on the ulna. It reinforces the annular ligament.
Upper extremity injuries
Youlian Hong, Roger Bartlett in Routledge Handbook of Biomechanics and Human Movement Science, 2008
Elbow dislocation: Due to the elbow’s relative stability, elbow dislocations are three times less common than shoulder dislocations (Praemer et al., 1999). The elbow is inherently stable due to its bony structure, primarily because of the close interaction between the trochlear notch of the ulna and the trochlea of the humerus, as well as the olecranon process of the ulna and the olecranon fossa of the humerus (Ring, 2006). On the radius, the coronoid process and radial head contact the coronoid and radial fossae of the humerus. The ulnar collateral ligament and lateral collateral ligament complexes, with the anterior capsule, account for the majority of the elbow’s stability. Nevertheless, elbow dislocations do occur, and when they do happen, considerable soft tissue damage occurs, frequently with rupture of the ulnar and lateral collateral ligaments.
Baseball
Ira Glick, Danielle Kamis, Todd Stull in The ISSP Manual of Sports Psychiatry, 2018
The most commonly specific phobia is fear of re-injury upon returning to play after a severe injury, especially those requiring surgery and prolonged rehabilitation (e.g., ulnar collateral ligament or rotator-cuff repairs). This phobia is frequently accompanied by overthinking and self-doubt and symptoms include intense anticipatory worry about re-injury and autonomic activation including increased heart rate, sweating, tremor, hyper-alertness, inability to sleep, or hesitancy to play at full speed or with full contact (McDuff, 2016). Anxiety is usually triggered just prior to competition or practice and can increase with the perceived importance of performance. Fear of flying is also common given the extensive travel and likelihood of exposure to turbulent weather or aborted takeoffs or emergency landings. Following one of these events and usually accompanied by high stress levels for other reasons, flying produces arousal and constant worry with an inability to relax or sleep even on long flights.
High elasticity of the flexor carpi ulnaris and pronator teres muscles is associated with medial elbow injuries in youth baseball players
Published in The Physician and Sportsmedicine, 2022
Akira Saito, Kyoji Okada, Kazuyuki Shibata, Hiromichi Sato, Tetsuaki Kamada
Although various theories regarding the contributing factors to medial elbow injuries in youth baseball players have been proposed, repetitive elbow valgus stresses during throwing has been previously demonstrated as contributing to these types of elbow injuries [3,5,6]. The forearm flexor-pronator muscles as well as the ulnar collateral ligament (UCL) contributes to elbow joint stability against valgus force during throwing [7–9]. Muscle elasticity is known to increase according to repeated muscle contraction and high external load [10–12]. A previous study reported that youth baseball players with medial elbow injuries had high elasticity in the pronator teres (PT) [13]. However, the relationships between the elasticities of the other forearm muscles and medial elbow injuries in youth baseball players are unknown. In cadaveric biomechanical studies, several authors have reported that the flexor digitorum superficialis (FDS) or flexor carpi ulnaris (FCU) were the major contributors to elbow valgus stability [7,8,14]. Accordingly, youth baseball players with medial elbow injuries may have high elasticities in these forearm muscles on account of repetitive elbow valgus stress. Moreover, a previous study indicated that the muscle elasticity increased with pain [15]. It is likely that youth baseball players with elbow pain have higher elasticity of the forearm muscles than those without elbow pain.
Comparison of outcome between nonoperative and operative treatment of medial epicondyle fractures
Published in Acta Orthopaedica, 2020
Petra Grahn, Tero Hämäläinen, Yrjänä Nietosvaara, Matti Ahonen
Louahem et al. (2010) argued that damage to the main medial stabilizer of the elbow, the medial collateral ligament, has far greater influence on elbow joint stability and outcome than actual fracture displacement and recommended surgery in patients with a positive valgus stress test, regardless of amount of fracture displacement. We did not routinely examine elbow stability in our patients at time of injury, an examination that often requires sedation. At follow-up there was no difference between the 2 treatment groups regarding stability of the elbow under valgus load. Nearly half of the nonoperatively treated children had an elbow dislocation, which was a clearly higher rate than one-fourth in the surgically treated children, thus one could argue that good results in the nonoperatively treated group could in part be due to an intact ulnar collateral ligament as suggested by Gottschalk et al. (2012).
Epidemiology of shoulder and elbow injuries in National Collegiate Athletic Association wrestlers, 2009-2010 through 2013-2014
Published in The Physician and Sportsmedicine, 2018
Avi D. Goodman, John Twomey-Kozak, Steven F. DeFroda, Brett D. Owens
The most common injuries were ulnar collateral ligament (UCL) tears, shoulder impingement, acromioclavicular (AC) sprain, and rotator cuff tears (Table 1). Injuries to the shoulder were most common (69.0%), followed by elbow (27.8%), and upper arm (3.2%). Taken together, elbow instability injuries (dislocation, hyperextension, and UCL tear) comprised 19.8% of injuries (4.27/10,000 AEs incidence), while shoulder instability injuries (anterior and posterior dislocation/subluxation, multidirectional instability, and non-SLAP glenoid labrum tear) were 13.7% of all injuries (incidence 2.96/10,000 AEs). Of all injuries, 91.6% were acute, compared to 7.4% that were recurrent from a previous academic year and 1.0% recurrent from the same academic year.
Related Knowledge Centers
- Medial Epicondyle of The Humerus
- Olecranon
- Ligament
- Ulna
- Elbow
- Humerus
- Radial Collateral Ligament of Elbow Joint
- Medial Epicondyle of The Humerus
- Coronoid Process of The Ulna
- Intermediate Fibers
- Triceps