Elbow extension test

Dr Henry Knipe et al.

The elbow extension test is a clinical decision rule aimed at reducing the number of unnecessary elbow radiographs in patients aged ≥3 years. 

The test has a specific examination whereby the seated patient, with the arm in supination and 90º shoulder flexion, is asked to fully extend the elbow to a locked position.

50% of patients who cannot fully extend their elbow have an ~50% risk of elbow fracture and radiography is recommended. Patients who can fully extend their elbow and an olecranon fracture is not suspected, radiography is recommended if symptoms persist beyond 7-10 days. 

The elbow extension test has a reported sensitivity of 96.8% and specificity of 48.5% for detecting elbows fractures with a negative predictive value of 98.4% in adults (age ≥15 years) and 95.8% in children aged 3-15 years. 

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rID: 54692
Tag: refs
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