My name is Doctor J. Michael Bennett, I am a member of Fondren Orthopedic Group, and
I am a board certified orthopedic surgeon specializing in surgery of the shoulder, elbow,
and knee. I am also a certificate of added qualification in sports medicine. Today I
want to talk about a couple of things in elbow pain, and these things may not be as common,
but they do present themselves, but it's something to look for and make sure that your orthopedic
surgeon or your physician look for them as well and know what to look for as well.
A lot of times, patients come into our office that may have a history of a traumatic injury
where they had a fall on an outstretched hand, where they may have a twisting injury, or
even an elbow dislocation. Most of the times, these patients heal up fine because the ligaments
stabilize themselves and the elbow becomes stable. But one possibility or one potential
outcome is to have an unstable elbow in one particular area, and that's called the posterolateral
area of the elbow. That's usually due to a deficient ligament in that region.
Looking at the elbow joint, this is a very good picture of the elbow. You've got three
articular areas, the radius, the ulna, and then you've got the distal humerus of the
elbow. You have three bones basically. They articulate at one spot. The radiocapitellar
joint is on the outside, which we call the lateral side of the elbow, on the outside
of the elbow and you can see all of these ligaments here that help stabilize and almost
wrap around that radial head. So this is basically what it looks like without the ligaments there,
but what can happen sometimes is if you have a dislocation of the elbows, when the joint
literally pops out like that. If you have a posterolateral injury of the elbow, the
radial head, which is this bone right here, slides out posteriorly and lateral, hence
the name posterolateral.
What that means is that the ligament here, which is called the lateral ulnar collateral
ligament, which inserts from out here at the lateral epicondyle and sweeps underneath this
radial head which is right here, acting like a hammock, and almost encompasses that radial
head. So it keeps that radial head and joint in an alignment. What happens when that ligament
gets disrupted, if the ligament's torn like that, what happens is this radial head here
likes to pop out a joint. People will notice that when they're reaching out for something,
when they're rotating their hand, they may feel a clunk or a pop.
One way to test for this is if you get yourself next to a table or bedside, and you rotate
your hands. This is called supination and you put your hands on the side of the table
or bed, and you bend your elbows and then you push up. Okay. This is like a push off
test or a chair push off test and the reason why that this will elicit symptoms is because
you're rotating your elbow and you're rotating that radiocapitellar joint, and you're providing
a stress. Within that stress, if you rotate the elbow and it slides out of joint, and
then you stress it and feel a clunk or you feel a sharp pain, then that is definitely
a positive finding. Sometimes an MRI arthogram is necessary to look at that ligament and
make sure it's still intact.
That being said, if you have any issues regarding elbow, we have information on our website
at orthopedicsports.com as well as jmichaelbennett.com or feel free to come to us at the clinic at
281-633-8600. We'd be happy to take a look at you. Thank you.