• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.1 no.1
• /
• pp.65-74
• /
• 1995

There is no line of demarcation between the shoulder and elbow regions. Pain In the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct localization is good. Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements. 1. Four. Passive extension, flexion, pronation, supination-full range, LOM, painful, painless. 2. Four. Resisted extension, flexion, pronation, supination-strong, weak, painful, painless. 3. Two. Resisted flexion, extension at the wrist-painful, painless. The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affected is not functionally a part of the elbow (i. e. Tennis elbow and Golfer's elbow).

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.84-88
• /
• 2011

Purpose: We report here on two cases of calcific tendinitis at the origin of the common extensor tendons of the forearm. Materials and Methods: A 42 year-old female complained of left elbow pain and flexion contracture. After obtaining the simple radiographs and MRI, surgical excision of the calcific deposits was done under the diagnosis of calcific tendinitis. A 25 year-old female complained of right elbow pain and a limited range of motion. Simple radiographs showed a calcific deposit just distal to the lateral epicondyle, and then she was managed with extracorporeal shock wave therapy. Results: The pain disappeared completely and both patients regained a full range of motion after treatments. Conclusion: Calcific tendinitis at the origin of the common extensor tendons of the forearm should be included in the differential diagnosis of the lateral elbow diseases that cause pain and a limited range of motion.

• Clinics in Shoulder and Elbow
• /
• v.18 no.1
• /
• pp.8-12
• /
• 2015

Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. Conclusions: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

• Clinical Pain
• /
• v.20 no.1
• /
• pp.1-6
• /
• 2021

Ultrasonography (US) of the elbow is an increasingly utilized modality for a variety of diagnoses. In this brief review, US findings for the pathologic conditions of forearm and elbow are described. The most common pathologies discussed here include distal biceps tendon and triceps tendon lesions, medial and lateral epicondylopathies, ulnar collateral ligament tears, ulnar nerve subluxation, joint effusions, and intra-articular bodies.

• Clinics in Shoulder and Elbow
• /
• v.10 no.1
• /
• pp.50-58
• /
• 2007

Purpose: To report our experience with nine cases of pathologic synovial plica on radiohumeral joint which symptom of painful snapping elbow was improved by arthroscopic resection. Materials and Methods: Between 1999 and 2004, 43 cases of elbow arthroscopy were performed by one surgeon. Eight patients with nine cases showed pathologic synovial plica in conjunction with snapping or posterolateral elbow pain. The mean age of eight patients (man: 7, woman: 1) was 29 years (range $16{\sim}56$ years). All patients had a trial of conservative treatment at least six months (range $6{\sim}16$ months). The diagnosis was confirmed before surgery in six cases and at the time of surgery in three cases. Pain, snapping, and subjective results were evaluated at least 12 months in the average(range $12{\sim}24$). Results: All patients showed a hypertropic lateral synovial plica with local synovitis. Seven of them had an associated lesion of chondromalacia on radial head. One of them was associated with radiocapitellar arthritis and had a wrapping over the radial head. Six patients experienced improved posterolateral pain at the end of study (VAS<1). However, the other two patients had occasional pain with activity. One of them persisted with mechanical symptoms, which was treated with additional arthroscopic procedure. Conclusion: Synovial plica in elbow should be considered as an important entity of common elbow disease, especially when pain in the lateral aspect of the elbow with a snapping sensation during motion is featured in patients. The arthroscopic resection seems to be safe and efficient in the short and long term treatment of plica in the elbow joint.

• Clinics in Shoulder and Elbow
• /
• v.1 no.2
• /
• pp.242-249
• /
• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• Clinics in Shoulder and Elbow
• /
• v.21 no.3
• /
• pp.162-168
• /
• 2018

An intra-articular osteoid osteoma is a very rare cause of elbow pain, and its diagnosis and treatment remain challenging. Delayed diagnosis may lead to arthritic change of the joint. In this study, the authors present the occurrence of intra-articular osteoid osteoma in the right elbow of a 15-year-old male patient who presented with prolonged pain and limited motion owing to delayed diagnosis. After confirming the nidus of osteoid osteoma from radiographic evaluation, the lesion was completely removed arthroscopically. The patient presented a complete relief of symptoms and full range of motion. This is the first domestic report of successful arthroscopic treatment of an intra-articular osteoid osteoma of the elbow.

• Physical Therapy Rehabilitation Science
• /
• v.5 no.4
• /
• pp.163-169
• /
• 2016

Objective: The purpose of this study was to investigate the effects of vibration resistance exercise (VRE) in patients with tennis elbow on strength, range of motion (ROM), function, pain and quality of life (QOL). Design: Randomized controlled trial. Methods: Twenty-seven participants were randomly assigned to either the VRE group (n=9), weight resistance exercise (WRE) group (n=9) or control group (n=9). Each group underwent hot compress for 15 minutes and electrotherapy for 15 minutes. The VRE group underwent exercises using a vibrating ball for 5 minutes. The WRE group underwent exercises using dumbbells for 5 minutes. All participants were evaluated on wrist extension strength using a hand-held dynamometer, grip strength level through an electric dynamometer, and ROM through a smartphone goniometer application before and after intervention. Patient-rated tennis elbow evaluation, Visual Analogue Scale and Short Form 8 were measured by questionnaires. Results: There were showed significant differences among the VRE, WRE and control group in wrist extensor muscle and hand grip strength, ROM, elbow function, pain and QOL after intervention (p<0.05). The VRE group showed a greater significant improvement in wrist extensor muscle strength and elbow function compared with the others (p<0.05). The VRE and the WRE groups had a more significant improvement in wrist extensor muscle and hand grip strength, ROM and pain compared with the control group (p<0.05). However, there were no significant differences in QOL among the three groups. Conclusions: Combining VRE with thermotherapy and electrotherapy appears to be more effective in improving wrist extension strength, ROM, elbow function, QOL in tennis elbow patients.

• The Journal of Korean Physical Therapy
• /
• v.16 no.3
• /
• pp.176-191
• /
• 2004

The purpose of this study was to find the effects of the eccentric exercise induced delayed muscle soreness on proprioception, muscle strength, muscle fatigue, and muscle pain of the elbow flexor muscles. Thirty one healthy male subjects were participated in this study. Before resisted eccentric exercise of the elbow flexors and immediately and at 1, 3, 5, and 7 days post-exercise, pain threshold, proprioception, tension tracking, initial median frequency, and fatigue index were measured. Pain pressure threshold and visual analog scale (VAS) was used to measure muscle pain. Proprioception of the elbow joint was measured by using 3 dimension motion analysis system. Maximum isometric contraction was measured by using digital tensiometer. Electromyography and power spectrum analysis was used to measure initial median frequency (IMF) and fatigue index (FI). Immediately post-exercise, a significant decrease pain threshold was observed that continued to 5 days post-exercise. VAS score was significantly increased at 1 and 3 days post-exercise compared to that of immediately post-exercise. Maximum isometric contraction, IMF, tension tracking ability of the exercised elbow joint were significantly decreased at 1, 3, and 5 days post-exercise compared to that of pre-exercise. FI was significantly increased at 1 and 3 days post-exercise compared that of pre-exercise. Proprioception sense of exercised elbow joint was significantly decreased immediately and at 1, 3, and 5 days post-exercise compared to that of pre-exercise. Proprioception sense of the contralateral elbow joint was significantly decreased immediately post-exercise compared to that of pre-exercise. However, proprioception sense that was measured in close chain kinematic position was not significantly difference between pre-exercise and post-exercise. These results could be useful to determine the resume time for exercising and participating sports activities.

• Clinics in Shoulder and Elbow
• /
• v.12 no.1
• /
• pp.67-75
• /
• 2009

Purpose: This study evaluated the clinical outcomes of debridement arthroplasty using the posteromedial approach in elbow joints with pain and bony limitation of motion. Materials and Methods: This study involved 16 elbows in 16 patients with pain and bony limitation of motion, which were treated by debridement arthroplasty using the posteromedial approach from March 2005 to March 2008. The mean follow up period was 27.6 (13~52) months. The clinical outcomes were analyzed using the Visual Analogue Scale(VAS) for pain scale, the preoperative and postoperative range of motion and the Mayo Elbow Performance Scores(MEPS). Results: The VAS was decreased significantly from a preoperative mean of 4.5 to a postoperative mean 1.1 (p<0.001). The average arc of motion improved significantly from $61.6 (0~90)^{\circ}$ preoperatively to $109.4 (80-120)^{\circ}$ postoperatively (p<0.001). The MEPS also improved significantly from 59.4 to 85.6 postoperatively (p<0.001). There were no complications, such as hematoma and elbow instability. Conclusion: Debridement arthroplasty using the posteromedial approach is a useful surgical procedure in the elbow joint with pain and bony limitation of motion, where all compartments can be debrided, the ulnar nerve can be manipulated easily and damage to the medial collateral ligament can be minimized.