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EP-12 Clinical Cases

Elbow Injury - Football


Naik, Heli FACSM; Deitch, John R.; Trojian, Thomas H. FACSM

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Medicine & Science in Sports & Exercise: August 2021 - Volume 53 - Issue 8S - p 407
doi: 10.1249/01.mss.0000763968.67834.a2
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ACSM Abstract Submission 2021 – Edited Character CountAbstract Title: Elbow Dislocation During Football

HISTORY: 17 y.o. male injured during a HS football game. He was the ball carrier and had a hyperextension injury of his L elbow. He reported that he was unable to feel his elbow and that he was feeling pain with straightening. Reported some numbness of his pinky.

PHYSICAL EXAMINATION: Inspection: prominent olecranon, forearm that appears foreshortenedROM: Was able to do thumbs up, OK sign. Difficulty with crossing his 2nd and 3rd finger. Mild tenderness over the medial elbow without crepitus. No swelling or joint effusion 2+ radius pulse<2 sec capillary refill

DIFFERENTIAL DIAGNOSIS: Simple Posterior Elbow DislocationComplex Posterior Elbow dislocationOlecranon fx w/ displacementUCL tear with lateral insufficiency

TESTS AND RESULTS: None – Sideline assessment and management

FINAL WORKING DIAGNOSIS: Simple Posterior Elbow Dislocation

TREATMENT: Prone position on evaluation table. Traction was applied at the humerus pulling towards the GH joint while someone wrapped thumbs around the olecranon which is posteriorly dislocated until reduced.

POST - REDUCTION PHYSICAL EXAMINATION: L Elbow:Inspection: NormalFROMAble to do thumbs up, OK sign, and crisscross with mild pain. Some TTP over the med epi and UCL. Mild effusion2+ radius pulse<2 sec capillary refill

OUTCOMES: Day 2: Placed in locked hinged braceDay 4: Begin working with PT on gentle ROM and unlock brace as tolerated4 Weeks later:Subjective: Denies any pain, numbness/tingling. States he is ready to get back. Brace unlocked to 20 degreesObjective: Improvement in ROM with lack of 10 deg of flex and 20 deg of ext. No elbow effusion. No TTP. Stable collaterals. 5/5 strength. Plan: Continue with elbow brace and formal PTCan return to FB in the braceFollow up in 1 month for re-evaluation11 weeks:Subjective: Denies any pain, numbness/tingling. Weaned out of brace with no complaints. Objective: Improvement in ROM with full flex and lack of 5 degrees of ext. No elbow effusion. No TTP. Stable collaterals. 5/5 strength. Plan: Follow up as needed

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