Milking Maneuver: Difference between revisions
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<div class="editorbox"> '''Original Editor '''- [[User:Anas Mohamed|Anas Mohamed]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | <div class="editorbox"> '''Original Editor '''- [[User:Anas Mohamed|Anas Mohamed]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | ||
=== Purpose === | === Purpose === | ||
'''Milking Maneuver''' is a [https://www.physio-pedia.com/Elbow_Ligamentous_Injuries?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share elbow ligamentous injury] test which evaluates the anterior and posterior bundle of the ulnar collateral ligament ( | '''Milking Maneuver''' is a [https://www.physio-pedia.com/Elbow_Ligamentous_Injuries?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share elbow ligamentous injury] test which evaluates the anterior and posterior bundle of the ulnar collateral ligament (Valgus instability).<ref name=":0">Karbach LE, Elfar J. [https://scholar.google.com/scholar_url?url=https://www.sciencedirect.com/science/article/pii/S0363502316310553&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=4037752522974006130&ei=LVSwYqqGI4OM6rQP9tS_0AU&scisig=AAGBfm2cyyIVCHlpy0V1R5DA8J4dq0SecQ Elbow Instability:] Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing. J Hand Surg Am. 2017 Feb;42(2):118-126. doi: 10.1016/j.jhsa.2016.11.025. PMID: 28160902; PMCID: PMC5821063.</ref><ref name=":1">Erickson, Brandon & Harris, Joshua & Chalmers, Peter & Bach, Bernard & Verma, Nikhil & Bush-Joseph, Charles & Romeo, Anthony. (2015). [https://scholar.google.com/scholar_url?url=https://journals.sagepub.com/doi/abs/10.1177/1941738115607208&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=352230412025878152&ei=S1SwYs2EIcKN6rQP-9Ca6AM&scisig=AAGBfm2FL4WhZa8UdyLrkYClzETVcXzMaA Ulnar Collateral Ligament Reconstruction:] Anatomy, Indications, Techniques, and Outcomes. Sports health. 7. 511-517. 10.1177/1941738115607208. </ref><ref name=":2">Patel, Ronak & Lynch, T. Sean & Amin, Nirav & Calabrese, Gary & Gryzlo, Stephen & Schickendantz, Mark. (2014). [https://scholar.google.com/scholar_url?url=https://www.orthopedic.theclinics.com/article/S0030-5898(14)00044-3/abstract&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=11590001405890348092&ei=Z1SwYvrfBqCM6rQP46yK0AU&scisig=AAGBfm3LHz1YgjBK-soDsfFrM1SNrGrq3Q The Thrower's Elbow]. The Orthopedic clinics of North America. 45. 355-376. 10.1016/j.ocl.2014.03.007. </ref><ref name=":3">Freehill, Michael T. MD; Safran, Marc R. MD, FACSM [https://scholar.google.com/scholar_url?url=https://journals.lww.com/acsm-csmr/fulltext/2011/09000/Diagnosis_and_Management_of_Ulnar_Collateral.8.aspx&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=7319564396914011112&ei=nVSwYovlOpyR6rQPoaOg2Ak&scisig=AAGBfm0u2_8SJI1ppGzcX2h5nyVTU_3IDA Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers, Current Sports Medicine Reports:] September 2011 - Volume 10 - Issue 5 - p 271-278 doi: 10.1249/JSR.0b013e31822d4000 </ref> | ||
doi: 10.1249/JSR.0b013e31822d4000 </ref> | |||
=== Technique === | === Technique === | ||
==== Milking Maneuver | ==== Milking Maneuver ==== | ||
'''Step 1.''' Patient position | '''Step 1.''' Patient position: Standing or sitting. | ||
'''Step 2.''' Patient forearm is supinated and elbow is flexed 90 degree. | '''Step 2.''' Patient's forearm is supinated and elbow is flexed to 90 degree. | ||
'''Step 3.''' Then examiner pulls patient | '''Step 3.''' Then examiner pulls the patient's thumb laterally which gives elbow valgus stress. | ||
'''Step 4.''' Pain, instability and apprehension shows positive sign. | '''Step 4.''' Pain, instability and apprehension shows positive sign. | ||
'''Step 5.''' Comparison can be done with the contralateral elbow. | '''Step 5.''' Comparison can be done with the contralateral elbow.<ref name=":1" /><ref name=":2" /> | ||
==== Modified Milking Maneuver | ==== Modified Milking Maneuver ==== | ||
'''Step 1.''' Patient position | '''Step 1.''' Patient position: Standing or sitting. | ||
'''Step 2.''' Patient forearm is supinated and elbow is flexed 70 degree with shoulder adduction and | '''Step 2.''' Patient's forearm is supinated and elbow is flexed to 70 degree with shoulder in adduction and external rotation. | ||
'''Step 3.''' Then examiner pulls patient | '''Step 3.''' Then examiner pulls the patient's thumb laterally which gives elbow valgus stress. | ||
'''Step 4.''' Pain, instability and apprehension shows positive sign. | '''Step 4.''' Pain, instability and apprehension shows positive sign. | ||
'''Step 5.''' Comparison can be done with the contralateral elbow. | '''Step 5.''' Comparison can be done with the contralateral elbow.<ref name=":0" /><ref name=":3" />{{#ev:youtube|ezmqCnjQCbg|300}}<ref>Modified Milking Maneuver. Ccedseminars. Available from: https://youtube|ezmqCnjQCbg</ref>{{#ev:youtube|KhG6svSw3Ec|300}}<ref> Milking Maneuver. Check.physio. Available from: https://youtube|KhG6svSw3Ec</ref> | ||
< | |||
< | == References == | ||
== References | <div class="row"><references /> | ||
<references /> | [[Category:Elbow]] | ||
[[Category:Elbow - Conditions]] | |||
[[Category:Elbow - Assessment and Examination]] | |||
[[Category:Elbow - Special Tests]] | |||
[[Category:Elbow - Ligaments]] | |||
Latest revision as of 12:58, 20 June 2022
Purpose[edit | edit source]
Milking Maneuver is a elbow ligamentous injury test which evaluates the anterior and posterior bundle of the ulnar collateral ligament (Valgus instability).[1][2][3][4]
Technique[edit | edit source]
Milking Maneuver[edit | edit source]
Step 1. Patient position: Standing or sitting.
Step 2. Patient's forearm is supinated and elbow is flexed to 90 degree.
Step 3. Then examiner pulls the patient's thumb laterally which gives elbow valgus stress.
Step 4. Pain, instability and apprehension shows positive sign.
Step 5. Comparison can be done with the contralateral elbow.[2][3]
Modified Milking Maneuver[edit | edit source]
Step 1. Patient position: Standing or sitting.
Step 2. Patient's forearm is supinated and elbow is flexed to 70 degree with shoulder in adduction and external rotation.
Step 3. Then examiner pulls the patient's thumb laterally which gives elbow valgus stress.
Step 4. Pain, instability and apprehension shows positive sign.
Step 5. Comparison can be done with the contralateral elbow.[1][4]
References[edit | edit source]
- ↑ 1.0 1.1 Karbach LE, Elfar J. Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing. J Hand Surg Am. 2017 Feb;42(2):118-126. doi: 10.1016/j.jhsa.2016.11.025. PMID: 28160902; PMCID: PMC5821063.
- ↑ 2.0 2.1 Erickson, Brandon & Harris, Joshua & Chalmers, Peter & Bach, Bernard & Verma, Nikhil & Bush-Joseph, Charles & Romeo, Anthony. (2015). Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. Sports health. 7. 511-517. 10.1177/1941738115607208.
- ↑ 3.0 3.1 Patel, Ronak & Lynch, T. Sean & Amin, Nirav & Calabrese, Gary & Gryzlo, Stephen & Schickendantz, Mark. (2014). The Thrower's Elbow. The Orthopedic clinics of North America. 45. 355-376. 10.1016/j.ocl.2014.03.007.
- ↑ 4.0 4.1 Freehill, Michael T. MD; Safran, Marc R. MD, FACSM Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers, Current Sports Medicine Reports: September 2011 - Volume 10 - Issue 5 - p 271-278 doi: 10.1249/JSR.0b013e31822d4000
- ↑ Modified Milking Maneuver. Ccedseminars. Available from: https://youtube%7CezmqCnjQCbg
- ↑ Milking Maneuver. Check.physio. Available from: https://youtube%7CKhG6svSw3Ec
