Posterolateral rotatory instability (PLRI) of the elbow occurs secondary to an injury to the lateral ulnar collateral ligament and lateral stabilizing structures [2]. The lateral pivot-shift test (PST) is a clinical examination for diagnosing PLRI [1]. The test involves moving the elbow from full extension to flexion while applying simultaneous supination torque, valgus moment, and axial compression [2]; a positive result is characterized by ulnohumeral subluxation that is seen clinically as posterolateral movement of the radial head and an incongruent radiocapitellar joint [2]. The PST is difficult to reliably reproduce in an office setting [3]. This can be due to patient-guarding or inexperience of the examiner. It is likely that the experienced examiner may perform the test differently from the inexperienced examiner. The PST has not previously been characterized biomechanically in the laboratory. Thus, the objective of this study is to fully characterize the biomechanics of the PST for PLRI. We will evaluate the repeatability of the PST across multiple surgeons and determine how the clinician’s level of training affects their method of testing. These results will be useful in developing training guidelines to standardize PST application as well as to improve accuracy.
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ASME 2009 Summer Bioengineering Conference
June 17–21, 2009
Lake Tahoe, California, USA
Conference Sponsors:
- Bioengineering Division
ISBN:
978-0-7918-4891-3
PROCEEDINGS PAPER
Surgeon Experience Level Affects Mechanics of the Pivot Shift Test for Posterolateral Rotatory Instability of the Elbow
Thomas Chu,
Thomas Chu
University of California at San Francisco, San Francisco, CA
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Jen M. Ty,
Jen M. Ty
University of California at San Francisco, San Francisco, CA
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Bayram Orazov,
Bayram Orazov
University of California at San Francisco, San Francisco, CA
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Nicole Strauss,
Nicole Strauss
University of California at San Francisco, San Francisco, CA
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Oliver M. O’Reilly,
Oliver M. O’Reilly
University of California at San Francisco, San Francisco, CA
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Jenni M. Buckley,
Jenni M. Buckley
University of California at San Francisco, San Francisco, CA
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Lisa L. Lattanza
Lisa L. Lattanza
University of California at San Francisco, San Francisco, CA
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Thomas Chu
University of California at San Francisco, San Francisco, CA
Jen M. Ty
University of California at San Francisco, San Francisco, CA
Bayram Orazov
University of California at San Francisco, San Francisco, CA
Nicole Strauss
University of California at San Francisco, San Francisco, CA
Oliver M. O’Reilly
University of California at San Francisco, San Francisco, CA
Jenni M. Buckley
University of California at San Francisco, San Francisco, CA
Lisa L. Lattanza
University of California at San Francisco, San Francisco, CA
Paper No:
SBC2009-206560, pp. 761-762; 2 pages
Published Online:
July 19, 2013
Citation
Chu, T, Ty, JM, Orazov, B, Strauss, N, O’Reilly, OM, Buckley, JM, & Lattanza, LL. "Surgeon Experience Level Affects Mechanics of the Pivot Shift Test for Posterolateral Rotatory Instability of the Elbow." Proceedings of the ASME 2009 Summer Bioengineering Conference. ASME 2009 Summer Bioengineering Conference, Parts A and B. Lake Tahoe, California, USA. June 17–21, 2009. pp. 761-762. ASME. https://doi.org/10.1115/SBC2009-206560
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