Combined hyperextension and supination of the elbow joint induces lateral ligament lesions

Abstract

An epidemiological study suggested that the injury mechanism of 'handball goalie's elbow' may be hyperextension. The pathomechanics of hyperextension combined with supination was studied in ten macroscopically normal, male, cadaveric elbow joint specimens. The age of the donors was 28.8 years (range 18-45 years). Extension loading of the elbow was performed in an experimental three-dimensional (3D)-kinematic loading apparatus. The degree of extension increased by 16.7 degrees +/- 8.7 degrees after loading. Hyperextension loads induced significant joint laxity in joint flexion (< 50 degrees) during forced valgus, external and internal rotation, respectively, but not during forced varus. The hyperextension trauma produced three lesions: (1) anterior capsule rupture, (2) avulsion of the proximal insertion of both the medial and the lateral collateral ligaments, and (3) occasional single rupture of the lateral collateral ligament. The lesions indicate that combined hyperextension and supination represent a possible mechanism leading to 'handball goalie's elbow'.

The Effect of Acupuncture on Elbow Joint Sports Injuries Based on Magnetic Resonance Imaging

“…The medial collateral ligament of the elbow joint plays an important role in the movement of the elbow joint. Chronic elbow joint instability [ 16 ] mainly involves chronic injury of the elbow collateral ligament. MR can show the anatomy of the elbow collateral ligament and clearly distinguish the anterior medial collateral ligament.…”

Exploring the Causes and Effects of Elbow Dislocation: An Ex-Vivo Experimental Investigation Using Papio Anubis Baboon and Human Cadaver Models

“…Hyper-extension at the elbow joint is another known mechanism of elbow dislocation. Tydral designed in 26 an experiment to produce a combined hyper-extension and supination at the elbow joint and observed the lateral ligament lesions induced. In this study, ten elbow cadavers from five male donors with a mean age of 28.8 years were used.Relatively young donors were chosen since age-related changes are commonly expected in human tissue and specimens near the same age range as active athletes were wanted.…”

Systematisches Rehaprogramm für Handballtorhüter mit chronischen Ellenbogenproblemen

“…Viele Torhüter spielen daher trotz ihrer Beschwerden weiter, wodurch die betroffenen Strukturen keine Chance haben, sich zu erholen, und chronische Beschwerden wie wiederkehrende Schmerzen, Schwellungen, mediale Instabilität, neurogene Beschwerden oder sogar freie Gelenkkörper auftreten können. Dies führt auf Dauer nicht nur zu Misserfolgen in Training und Spiel, sondern auch zu Beeinträchtigungen im täglichen Leben (ADL) und kann letztlich ein Grund sein, das Torwartspiel aufzugeben 4 , 6 , 13 , 14 , 16 , 17 , 18 , 19 .…”