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Tears of Elbow Ligaments
Definition: A partial or complete discontinuity in the connective tissue fibre matrix comprising the medial and lateral collateral ligaments of the elbow.
Causes: The most common causes of tears of the elbow collateral ligaments are mechanical ones. The medial collateral ligaments (ulnar collateral) can be torn when a valgus force is introduced to the forearm whilst the arm is relatively fixed.
Examples include: arm wrestling, and repetitive throwing such as javelin or baseball throwers. In children, the medial epicondylar physis is weaker than medial collaterals, and chronic injury to this physis can result in arrested growth.
The lateral collateral ligaments (radial collateral) of the elbow are less frequently torn than their medial counter-parts. They can be damaged however, when a varus force is introduced to the forearm about a relatively fixed arm. Examples include: hyperextension injuries of the elbow with the forearm in pronation.
Examination: The presentation of elbow collateral tears will depend on their severity. Typically, medial and lateral elbow collateral tears will produce pain, oedema, and ecchymoses around the medial, and lateral aspect of the elbow respectively.
Orthopaedic tests for tears of elbow ligaments, medial and lateral collateral:
Introducing a valgus force at the elbow, with the elbow flexed at 30° will stress the medial collateral ligaments. A positive is indicated by an aggravation in symptoms.
Introducing a varus force at the elbow, with the elbow flexed at 30° will stress the lateral l collateral ligaments. A positive is indicated by an aggravation in symptoms.