Elbow Flexion Test

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed

Purpose

Elbow Flexion Test is a neurological dysfunction test used to determine the cubital tunnel syndrome (ulnar nerve ).

Technique

Step 1. Patient position in standing or sitting.

Step2. Ask the patient to actively fully elbow flexion with wrist extension and 90 degree shoulder gridle abduction and depression.

Step3. Hold this position up to 3 to 5 minutes.[1]

Step4. Positive sign indicates feeling numbness or tingling in distribution of ulnar nerve root.


Evidence

Elbow flexion test as the sensitive of (0.32) provocative test in the diagnosis of cubital tunnel syndrome when combined with pressure on the ulnar nerve.[4][5]

Research was done on 25 patients with cubital tunnel syndrome were tested preoperative and postoperative with 10 second elbow flexion test and 10 second shoulder internal rotation test. 80% of sensitivity in preoperative cases was in 10 second shoulder internal rotation test and 36% in elbow flexion test. This shows elbow flexion test as less sensitivity than shoulder internal rotation test.[6] )

References

  1. David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
  1. Rosati M, Martignoni R, Spagnolli G, Nesti C, Lisanti M. Clinical validity of the elbow flexion test for the diagnosis of ulnar nerve compression at the cubital tunnel. Acta Orthop Belg. 1998;64(4):366-370.
  2. Elbow Flexion Test for Cubital Tunnel Syndrome. Ccedseminars. Available from: https://youtu.be%7CmF3bUpeQfzs
  3. Ulnar Nerve, Clinical Examination - Everything You Need To Know - Dr. Nabil Ebraheim. nabil ebraheim. Available from: https://youtube%7CPTpUzXdBvpo
  4. Novak CB, Lee GW, Mackinnon SE, Lay L. Provocative testing for cubital tunnel syndrome. J Hand Surg Am. 1994;19(5):817-820. doi:10.1016/0363-5023(94)90193-7
  5. Buehler MJ, Thayer DT. The elbow flexion test. A clinical test for the cubital tunnel syndrome. Clin Orthop Relat Res. 1988;(233):213-216.
  6. Ochi K, Horiuchi Y, Tanabe A, Morita K, Takeda K, Ninomiya K. Comparison of shoulder internal rotation test with the elbow flexion test in the diagnosis of cubital tunnel syndrome. J Hand Surg Am. 2011;36(5):782-787. doi:10.1016/j.jhsa.2010.12.019