Pathologies of the Elbow Andrews University肘关节的病理学.pptVIP

Elbow Lateral Epicondylitis (tennis elbow) Pathology 30 – 50 years old Repetitive micro-trauma Chronic tear in the origin of the extensor carpi radialis brevis Lateral Epicondylitis (tennis elbow) Mechanism of Injury Overuse syndrome caused by repeated forceful wrist and finger movements Tennis players Prolonged and rapid activities Lateral Epicondylitis (tennis elbow) Clinical Signs and Symptoms Increased pain around lateral epicondyle Tenderness in palpation CET Tests AROM; PROM Resisted tests Lidocaine Treatment of Tennis Elbow Medial Epicondylitis (golfer’s elbow) Pathology 30 - 50 years old Repetitive micro trauma to common flexor tendon Medial Epicondylitis (golfer’s elbow) Mechanisms of injury Throwing a baseball Racquetball or tennis Swimming backstroke Hitting a golf ball Medial Epicondylitis (golfer’s elbow) Clinical signs and symptoms Increased pain over medial epicondyle Tenderness on palpation CFT Tests AROM; PROM Resisted tests Lidocaine Ulnar Neuritis Pathology Superficial position at the elbow Excessive pressure in this area Second most common entrapment neuropathy in the upper extremity Ulnar Neuritis Mechanism of injury Compression of the ulnar nerve: cubital tunnel (epicondyle, olecranon, MCL, arch of arcuate ligament and of 2 heads of FCU Elbow flexion tightens arch Repeated rapid activities such as throwing and prolonged flexion may traction or compress nerve Nerve can sublux out of tunnel Ulnar Neuritis Clinical signs and symptoms Sensory changes in classic ulnar distribution: little finger and ulnar side of ring finger Positive elbow flexion test Positive Tinel’s test Weakness of grip Deterioration of 2 point discrimination Adductor Pollicus neuro-weakness Neuro-weakness interossei (Wartenburg) Ulnar Neuritis Common treatments Non-operative: rest is imperative; NSAIDS; determination of cause and elimination of it Surgical intervention: decompression or transposition Medial Overload Syndrome in Throwers Pathol