Elbow extension sign
Original Editor - Nikki Arnold
Top Contributors - Evan Thomas, Nikki Arnold, Admin, Kim Jackson, Tony Lowe, WikiSysop, Johnathan Fahrner, Kai A. Sigel, Wanda van Niekerk and Amanda Ager
Purpose[edit | edit source]
To test the presence of either a bony fracture or for elbow joint effusion.[1] [2]
Technique[edit | edit source]
The patient extends elbow as far as possible while either supine or in a standing position. The examiner will assess to whether the patient achieves full extension.
A positive test is if the patient is unable to fully extend the elbow.[3]
Evidence[edit | edit source]
Table 1. Elbow extension test characteristics[4]
| Adults | Children | Combined |
| Fx | Fx+Effusion | Fx | Fx+Effusion |
Fx | Fx+Effusion | |
| Sensitivity |
98.4 | 97.3 | 94.6 | 93.7 | 96.8 | 95.8 |
| Specificity |
47.7 | 54.3 | 49.5 | 54.8 | 48.5 | 54.6 |
| LR+ | 1.88 | 2.13 | 1.87 | 2.07 | 1.88 | 2.11 |
| LR- | 0.03 | 0.05 | 0.11 | 0.11 | 0.06 | 0.08 |
Resources[edit | edit source]
Link to the full Appelboam et al 2009 article can be found here: http://tinyurl.com/oapzvy3
References[edit | edit source]
- ↑ Hawksworth CRE, Freeland P. Inability to fully extend the injured elbow: an indicator for significant injury? Arch of Emerg Med. 1991;8:253-256.
- ↑ Docherty MA, Schwab RA, Ma JO. Can elbow extension be used as a test of clinically significant injury? Southern Med J.2002 May;95(5):539-541.
- ↑ Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.
- ↑ Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higinson I, Klein JA, Le Roux S, Saranga SSM, Taylor R, Vicery J, Powell RJ, Lloyd G. Elbow extension test to rule out elbow fracture: multicentre prospective validation and observational study of diagnostic accuracy in adults and children. BMJ. 2008;337;a2428
