Orthopedic Tests: Elbow, Forearm, Wrist, & Hand

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mandelyn
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273774
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Orthopedic Tests: Elbow, Forearm, Wrist, & Hand
Updated:
2014-05-09 15:02:55
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Orthopedic tests for the elbow, forearm, wrist, and hand
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  1. Tennis Elbow Test
    • Explanation: With the client seated or standing the practitioner wraps one hand around client's elbow so the thumb is pressing on the extensor tendons just distal to the lateral epicondyle of the humerus.
    • Tests: Extensor muscles of the forearm/tennis elbow
  2. Golfer's Elbow Test
    • Explanation: With the client seated or standing the practitioner grasps the client's elbow so that the thumb is pressing on the flexor tendons just distal to the medial epicondyle of the humerus.
    • Tests: Flexor muscles of the forearm/golfer's elbow
  3. Elbow Flexion Test
    • Explanation: The client is standing or seated and brings both elbows into full flexion with forearms supinate and the wrists hyperextended.  If symptoms are reproduced within 60 seconds it is a positive test.
    • Tests: compression of the ulnar nerve in the cubital tunnel
  4. Pronator Teres Test
    • Explanation: Client is standing with elbow in 90o of flexion and the practitioner places one hand on the client's elbow for stabilization while the other hand grasps the client's hand in a handshake position.  The client holds this position as the practitioner attempts to supinate the client's arm and extend the elbow.
    • Tests: compression of median nerve by the pronator teres muscles
  5. Pinch Grip Test
    • Explanation: The client firmly pinches the tips of the thumb and index finger together.  If client is unable to do this without hyperextending the DIP joint it is a positive test.
    • Tests: compression of the anterior interosseous nerve at the elbow
  6. Phalen's Test
    • Explanation: The client presses the back of hands together so the wrists are flexed close to 90o.  Symptoms will be reproduced within 60 seconds
    • Tests: Carpal Tunnel Syndrome/ compression of median nerve
  7. Tinel's Sign
    • Explanation: The practitioner taps on the carpal tunnel at the base of the hand.  If neurological symptoms are reproduced with each tap, it is an indication of cts
    • Tests: Carpal Tunnel Syndrome
  8. Tethered Median Nerve Stress Test
    • Explanation: The wrist is held in extension and supination, while in this position the index finger is pulled into hyperextension.  This position is held for 60 seconds
    • Tests: Carpal Tunnel Syndrome
  9. Froment's Sign
    • Explanation: Client holds a piece of paper between the thumb and index finger as if holding a key and the practitioner tries to pull the paper out of the client's grip.
    • Tests: ulnar nerve compression
  10. Finkelstein Test
    • Explanation: Client pulls thumb into full flexion across the anterior surface of the palm.  The client then wraps their fingers around the thumb to hold it in place and either the client or practitioner then ulnar deviate the wrist.
    • Tests: de Quervain's tenosynovitis
  11. Upper Limb Neurodynamic Test #1
    • Explanation: The client is supine and the practitioner stands facing the client.  Clients elbow is flexed to 90o at the beginning of test.
    • 1. shoulder is brought into depression
    • 2. arm is abducted to about 110o
    • 3. Forearm is supinated
    • 4. wrist and fingers are hyperextended
    • 5. shoulder is laterally rotated
    • 6. elbow is extended
    • 7. neck is contralaterally flexed
    • Tests: median nerve
  12. Upper Limb Neurodynamic Test #2
    • Explanation: The client is supine and slightly diagonal on table so the shoulder of the test side is slightly off the table.  The practitioner stands near client's head facing the feet and places their thigh against client's shoulder to hold it in depression with shoulder in slight abduction.
    • 1. elbow is extended
    • 2. shoulder is laterally rotated, forearm is supinated
    • 3. wrist and fingers are hyperextended
    • 4. neck is contralaterally flexed
    • Tests: median nerve
  13. Upper Limb Neurodynamic Test #3
    • Explanation: The client is supine and slightly diagonal on table so the shoulder of the test side is slightly off the table.  The practitioner stands near client's head facing the feet and places their thigh against client's shoulder to hold it in depression with shoulder in slight abduction.
    • 1. elbow is extended
    • 2. shoulder is medially rotated, forearm pronated
    • 3. wrist and fingers are flexed
    • 4. neck is contralaterally flexed
    • Tests: radial nerve
  14. Upper Limb Neurodynamic Test #4
    • Explanation: The client is supine and the practitioner stands facing the client.  Clients elbow is extended at beginning of test.
    • 1. shoulder is depressed
    • 2. wrist and fingers are hyperextended
    • 3. forearm is pronated, shoulder laterally rotated
    • 4. elbow is flexed
    • 5. shoulder is abducted
    • 6. neck is contralaterally flexed
    • Tests: ulnar nerve

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