Lateral Pivot-Shift Test of the Elbow

 Lateral Pivot-Shift Test of the Elbow

  • Lateral Pivot-Shift Test of the Elbow is used for Lateral Ulnar Collateral Ligament Injury (PLRI)

  • Patient lies supine with affected arm overhead
  • forearm is supinated and valgus stress is applied while bringing the elbow from full extension to 40 degrees of flexion
  • with increased flexion triceps tension reduces the radial head
  • often more reliable on anesthetized patient

  • At 40° of flexion, the patient with posterolateral rotatory instability will note apprehension/pain as the radial head subluxates about the capitellum.
  • With further flexion, a clunk or sense of relief occurs as the joint is reduced.

  • Sensitivity: 100 % (In anesthetized patients)
  • Sensitivity: 38 % (In awake patients)

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