Lecture 11, Elbow and Forearm

Question 1

Etiologies for hypomobility

Answer 1

joint response after trauma, dislocations, fractures
immobility due to neurological impairment
degeneration: OA, RA

Question 2

most ADLs require what ROM at elbow joint?

Answer 2

30° - 130°, 100° arc

Question 3

Pediatric hyperextension

Answer 3

supracondylar fracture
FOOSH is most common mechanism
dislocation is the most common is posterior

Question 4

Myositis Ossificans

Answer 4

Formation of bone in atypical locations in the body
synonymous with heterotopic bone formation

Question 5

Etiology of myositis ossificans

Answer 5

uncommon, most frequent sites are elbow and thigh
result of trauma to brachialis or joint capsule
radial head fracture, fracture-dislocation, tear of brachialis tendon
can result from aggressive stretching and/or prolonged immobilization

Question 6

S/S of Myositis Ossificans

Answer 6

pain with resisted flexion
pain with passive extension
tender to palpation of distal brachialis

Question 7

Management of myositis ossificans

Answer 7

contraindicated–> passive stretching and resistance ex

protect area, maintain range
no treatment if asymptomatic
surgical excision is option

Question 8

What will the pt complain of with elbow hypomobility?

Answer 8

Pain at rest
shoulder pain from compensatory movement
holding things in palm of hand
unable to carry with straight arm
pushing up from cahir

Question 9

Acute stage of elbow hypomobility, structural impairments

Answer 9

joint effusion
muscle guarding
decrased motion
decreased joint play

Question 10

Subacute/chronic stage stage of elbow hypomobility, structural impairments

Answer 10

Capsular pattern, flexion is more restricted vs extension
PROM –> hard or boney end feel
pronation/supination limited

Question 11

Acute protection phase for elbow hypomobility

Answer 11

Educate pt
REduce effects of inflammation
Maintain soft tissue and joint mob
Maintain integrity and function of related areas

muscle setting, distractions, no sling

Question 12

subacute controlled motion phase for elbow hypomobility

Answer 12

increase soft tissue and joint mobility
improve muscle performance and functional abilities
continue progression through return to function

grade 3/4 distractions, isometrics, strengthening, functional

Question 13

Chronic lack of pronation/supination

Answer 13

possibility of angular deformity from malunion or nonunion