Elbow extension sign: Difference between revisions

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== Purpose<br> ==
== Purpose   ==


To test the presence of either a bony fracture or for elbow joint effusion.<ref name="Hawksworth and Freeland">Hawksworth CRE, Freeland P. Inability to fully extend teh injured elbow: and indictor for significant injury? Arch of Emerg Med. 1991;8:253-256.</ref><br>
To test the presence of either a bony fracture or for elbow joint effusion.<ref name="Hawksworth and Freeland">Hawksworth CRE, Freeland P. Inability to fully extend the injured elbow: an indicator for significant injury? Arch of Emerg Med. 1991;8:253-256.</ref>&nbsp;<ref name="Docherty et al">Docherty MA, Schwab RA, Ma JO. Can elbow extension be used as a test of clinically significant injury? Southern Med J.2002 May;95(5):539-541.</ref><br>


== Technique<br> ==
== Technique ==


The patient extends elbow as far as possible while either supine or in a standing position.&nbsp; The examiner will assess to whether the patient achieves full extension.
The patient extends elbow as far as possible while either supine or in a standing position. The examiner will assess to whether the patient achieves full extension.  


A positive test is if the patient is unable to fully extend the elbow.<ref name="Users's guide">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.</ref>
{{#ev:youtube|X8jQl_Cry5s}}
 
A positive test is if the patient is unable to fully extend the elbow.<ref name="Users' guide">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.</ref>  


== Evidence  ==
== Evidence  ==


Provide the evidence for this technique here
'''Table 1'''. Elbow extension test characteristics<ref name="Appelboam et al">Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higinson I, Klein JA, Le Roux S, Saranga SSM, Taylor R, Vicery J, Powell RJ, Lloyd G. Elbow extension test to rule out elbow fracture: multicentre prospective validation and observational study of diagnostic accuracy in adults and children. BMJ. 2008;337;a2428</ref>
 
{| style="text-align: left;" border="0" cellpadding="1" cellspacing="1"
|-
| style="width: 120px; height: 25px; text-align: center" | <br>
| style="width: 160px; height: 25px; text-align: center" | '''Adults'''
| style="width: 160px; height: 25px; text-align: center" | '''Children'''
| style="width: 160px; height: 25px; text-align: center" | '''Combined'''
|}
 
{| style="text-align: left;" border="0" cellpadding="1" cellspacing="1"
|-
| style="width: 120px; height: 25px;" | <br>
| style="width: 78px; height: 25px; text-align: center" | ''Fx''
| style="width: 77px; height: 25px; text-align: center" | ''Fx+Effusion''
| style="width: 78px; height: 25px; text-align: center" | ''Fx''
| style="width: 77px; height: 25px; text-align: center" | ''Fx+Effusion''<br>
| style="width: 78px; height: 25px; text-align: center" | ''Fx''
| style="width: 77px; height: 25px; text-align: center" | ''Fx+Effusion''
|-
| style="width: 120px; height: 25px;" | ''Sensitivity''<br>
| style="width: 78px; height: 25px; text-align: center" | 98.4
| style="width: 77px; height: 25px; text-align: center" | 97.3
| style="width: 78px; height: 25px; text-align: center" | 94.6
| style="width: 77px; height: 25px; text-align: center" | 93.7
| style="width: 78px; height: 25px; text-align: center" | 96.8
| style="width: 77px; height: 25px; text-align: center" | 95.8
|-
| style="width: 120px; height: 25px;" | ''Specificity''<br>
| style="width: 78px; height: 25px; text-align: center" | 47.7
| style="width: 77px; height: 25px; text-align: center" | 54.3
| style="width: 78px; height: 25px; text-align: center" | 49.5
| style="width: 77px; height: 25px; text-align: center" | 54.8
| style="width: 78px; height: 25px; text-align: center" | 48.5
| style="width: 77px; height: 25px; text-align: center" | 54.6
|-
| style="width: 120px; height: 25px;" | ''LR+''
| style="width: 78px; height: 25px; text-align: center" | 1.88
| style="width: 77px; height: 25px; text-align: center" | 2.13
| style="width: 78px; height: 25px; text-align: center" | 1.87
| style="width: 77px; height: 25px; text-align: center" | 2.07
| style="width: 78px; height: 25px; text-align: center" | 1.88
| style="width: 77px; height: 25px; text-align: center" | 2.11
|-
| style="width: 120px; height: 25px;" | ''LR-''
| style="width: 78px; height: 25px; text-align: center" | 0.03
| style="width: 77px; height: 25px; text-align: center" | 0.05
| style="width: 78px; height: 25px; text-align: center" | 0.11
| style="width: 77px; height: 25px; text-align: center" | 0.11
| style="width: 78px; height: 25px; text-align: center" | 0.06
| style="width: 77px; height: 25px; text-align: center" | 0.08
|}
 
<br>


== Resources  ==
== Resources  ==


add any relevant resources here  
Link to the full Appelboam et al 2009 article can be found here: http://tinyurl.com/oapzvy3 <br>


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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== References  ==
== References  ==


References will automatically be added here, see [[Adding References|adding references tutorial]].
<references />


<references />
[[Category:Assessment]]
[[Category:Special_Tests]]
[[Category:Elbow]]
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Elbow - Assessment and Examination]]
[[Category:Elbow - Special Tests]]

Latest revision as of 19:39, 31 January 2021

Original Editor - Nikki Arnold

Top Contributors - Evan Thomas, Nikki Arnold, Admin, Kim Jackson, Tony Lowe, WikiSysop, Johnathan Fahrner, Kai A. Sigel, Wanda van Niekerk and Amanda Ager

Purpose[edit | edit source]

To test the presence of either a bony fracture or for elbow joint effusion.[1] [2]

Technique[edit | edit source]

The patient extends elbow as far as possible while either supine or in a standing position. The examiner will assess to whether the patient achieves full extension.

A positive test is if the patient is unable to fully extend the elbow.[3]

Evidence[edit | edit source]

Table 1. Elbow extension test characteristics[4]


Adults Children Combined

Fx Fx+Effusion Fx Fx+Effusion
 Fx Fx+Effusion
Sensitivity
 98.4 97.3 94.6 93.7 96.8 95.8
Specificity
 47.7 54.3 49.5 54.8 48.5 54.6
LR+ 1.88 2.13 1.87 2.07 1.88 2.11
LR- 0.03 0.05 0.11 0.11 0.06 0.08


Resources[edit | edit source]

Link to the full Appelboam et al 2009 article can be found here: http://tinyurl.com/oapzvy3

References[edit | edit source]

  1. ↑ Hawksworth CRE, Freeland P. Inability to fully extend the injured elbow: an indicator for significant injury? Arch of Emerg Med. 1991;8:253-256.
  2. ↑ Docherty MA, Schwab RA, Ma JO. Can elbow extension be used as a test of clinically significant injury? Southern Med J.2002 May;95(5):539-541.
  3. ↑ Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.
  4. ↑ Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higinson I, Klein JA, Le Roux S, Saranga SSM, Taylor R, Vicery J, Powell RJ, Lloyd G. Elbow extension test to rule out elbow fracture: multicentre prospective validation and observational study of diagnostic accuracy in adults and children. BMJ. 2008;337;a2428
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