Elbow Sprain

Elbow sprains are commonly occurring injuries, yet they must be distinguished from other types of elbow injuries, such as fractures, dislocations, osteochondritis dissecans, growth plate injuries, congenital abnormalities, and common neurovascular injuries such as ulnar neuritis. A diagnosis of elbow sprain refers to an injury to either the medial or lateral ligament complexes of the elbow. The ligaments play important roles in maintaining elbow joint stability, particularly in the setting of functional movement such as throwing. For example, stresses across the medial elbow joint have been found to reach velocities of greater than 2,300 degrees per second during the acceleration phase of throwing, and valgus torque is reported to have reached 64 Newton meters (N m) in the late cocking phase. The static strength of the ulnar collateral ligament (UCL) measures about 32 N m in elbow flexion; thus, the remainder of medial elbow stability is provided by the bony and other soft tissue structures in the elbow. Elbow ligament injuries often occur in association with or as a result of other injuries, such as elbow dislocations. Medial injuries occur more frequently than lateral ligament injuries. The most common complication of either a medial (ulnar) collateral ligament or a lateral collateral ligament elbow injury is chronic structural or functional instability. This can lead to poor outcomes and a variety of complications, such as decreased range of motion (ROM), arthritis, nerve palsies, weakness, and heterotopic ossification. All athletes with elbow pain must be evaluated promptly for signs of ligamentous injury. The presenting history varies from acute or chronic elbow pain, clicking, catching, or snapping to a spectrum of giving way/subluxation with flexion/pronation in medial injuries or extension/supination with lateral injuries.