Ligamentous Injury

Question 1

(1) Ulnar collateral ligament is primary structure that resists ______ at the elbow
(2) Trauma to this ligament is ____
(3) Common injury to ulnar collateral ligament comes from excessive _______ motions (baseball pitcher)
(4) Repetitive valgus stress to the elbow may result in instability or disability of the ulnar collateral ligament

Answer 1

1) valgus stress
2) rare
3) overhead throwing

Question 2

Dx/ Tx
Symptoms
(1) With acute onset patient will describe a “pop” while throwing
(2) Most commonly patients experience a gradual onset of symptoms with progressive
medial elbow pain with valgus stresses
(3) May experience symptoms consistent with ulnar neuritis
Physical Exam
(1) Visual = Generally edema and ecchymosis are absent
(2) Palpation = Tenderness over ulnar collateral ligament
(3) ROM = Possible loss of terminal elbow extension
(4) Muscle Test = Usually unremarkable or limited by pain
(5) Special Tests
(a) Positive Moving valgus stress test-valgus stress is applied to elbow while moving elbow into full flexion and extension. Test is positive when more pain is felt between 70 degree and 120 degrees of flexion.

Answer 2

Ulnar Collateral Ligament Tear
Treatment
(1) Light Duty- Activity Modification
(2) Ice for acute injury
(3) NSAIDS
(4) Pain free elbow and wrist stretching and strengthening exercises

Question 3

Referral Decisions/Red Flags
(1) Failed nonsurgical management in patients that consistently perform activities that result valgus stress should be consulted to ________.

Answer 3

orthopedics