Elbow stabilisers and how to test them

Elbow biomechanics: Soft tissue stabilizers Kaufmann, R., Wilps, T., Musahl, V., & Debski, R. Level of Evidence: N/A Follow recommendation: N/A Type of study: Anatomical Topic: Elbow ligaments - Biomechanics This is a narrative review on the passive elbow structures contributing to valgus and varus stability of the elbow joint. No systematic process was followed. The authors report that valgus flexibility at the elbow is greatest at 30° of flexion. The medial ulnar collateral ligament (MUCL) resists these valgus forces. The MUCL is divided in anterior and posterior bundles, with the anterior bundle being the main source of valgus stability. The MUCL (anterior bundle) tightens incrementally with elbow flexion, reaching highest tension at 80° of elbow flexion. The anterior and posterior portion of the MUCL (anterior bundle) are stretched during full elbow extension and flexion respectively. The lateral collateral ligaments of the elbow passively control varus forces and they consist in the lateral ulnar collateral ligament (LUCL) and the radial collateral ligament (RCL). The stabilisation role of the two is debated, however, it is believed that both control varus forces and are important in the postero-lateral rotatory stability of the elbow. Clinical Take Home Message: Hand therapists could perform valgus stress testing in 30° of elbow flexion to reveal the greatest laxity. Valgus testing in full elbow extension and flexion should reveal greater stability and they will stress the anterior and posterior portions of the MUCL respectively. Injury to the lateral collateral ligaments should alert clinicians to the possibility of patients presenting with postero-lateral rotatory instability of the elbow. URL: https://www.jhandsurg.org/article/S0363-5023(19)31477-7/pdf