Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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FUNCTIONAL EXAMINATION OF THE ELBOW

PASSIVE TESTS

Passive flexion

Positioning.
The subject stands with the arm outstretched. The examiner stands level with
the subject’s arm. He places one hand against the back of the shoulder and grasps the distal forearm with the other hand.

Procedure.
Bring the hand towards the shoulder,thereby stabilizing the latter, until the movement comes to a stop.

Common mistakes.
Inadequate stabilization allows the shoulder to move backwards.

Normal functional anatomy:

• Rm’ge: about 160°
• Elld-feel:
– in well muscled subjects: a soft stop by tissue approximation, the muscles of the
forearm coming in contact with the muscles of the upper arm
– in poorly muscled subjects: a rather hard stop of bone engaging with bone.
• Limitillg structures:
– in well muscled subjects: the muscular masses of the upper arm and forearm
coming in contact with each other
– in poorly muscled subjects: bony contact between the coronoid fossa of the
humerus and coronoid process of the ulna and the head of the radius and radial
fossa of the humerus
– tension in the posterior part of the joint capsule.

Common pathological situations:

• Painful limitation occurs in arthritis (as part of the capsular type of limitation) or when a loose body is present in the anterior part of the jOint .
• Painless limitation is present in uncomplicated arthrosis.

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