varus stress test elbow

specified cutoff points for radiocapitellar Also, the fluoroscopy is valuable to dynami-incongruity and axial ulnohumeral incongruity in cally assess the elbow under varus and valgus patients with posterolateral rotatory instability stress (in full extension and 30 of flexion) and to [19]. Elbow Varus Stress Test [Video File] Lateral Epicondylitis Test Patient position: Seated, with elbow flexed and forearm supported by table Examiner action: Palpate the lateral epicondyle . What does a varus stress test test for? This test is considered positive if the patient experiences pain or excessive laxity is noted and compared to the contralateral side. The ipsilateral anterior rotation test is conducted in order to assess the anterior movement of a patient's ilium in relation to the sacrum. Two patients had cubitus varus The Valgus Stress Test for LCL injuries has hardly been evaluated regarding its diagnostic accuracy. We're dedicated to providing you the best of CBD, News, with a focus on dependability and News, CBD, Marketing, Technology, Business, Review and Health Blog. Valgus/varus stress test for elbow. Unfortunately, no literature is available providing information about the reliability and accuracy of this test. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. Elbow Varus and Valgus Stress Tests Watch on Video or Sound Issues? Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Orthopaedic: Examination, evaluation, and intervention (2nd ed.). Think About These Ways To Change Your ICO Promotion, Webb Telescope Reveals An Image Of The First Galaxies Ever : Npr, Quick, The Worlds Largest Radio Telescope, Zooms In On A Furious Cosmic Source Nj Org Politics, News And Prime Nj Actual Estate Brokers, 12 Stats About Kidding Ourselves Workers Carry Out Properly From To Make You Look Sensible Around The Water Cooler, The Internets High 8 Deer Trail Digicam Photos Whitetail Deer Hunting, Whitetail Looking, Huge Deer. If you are a patient, seek care of a health care professional. Awesome! The Varus Instability (Stress) Test at the elbow is a common orthopedic test to assess the integrity of the lateral collateral ligament at the elbow joint. Also for beginners! Answer: B. The examiner grasps the patient's thumb under the forearm and pulls it imparting a valgus stress to the elbow. with previous dislocations, three with a varus stress injury, and three unknown causes. The Varus Instability (Stress) Test at the elbow is a common orthopedic test to assess the integrity of the lateral collateral ligament at the elbow joint. Videos to help you sharpen your examination skills. This is a important test to do when examine the posterolateral instability of the knee joint. The Varus Test of the knee is positive if pain or excessive motion is elected on the lateral side of the knee joint compared with the other extremity. followers. [1] The test can be repeated in varying degrees of elbow flexion, but generally it is positioned between 5 and 30 degrees. Available from: I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Every physical or physiotherapist should own it. DOES "TOTAL CONTACT" NO THUMB TEST. Thats what I did. Long sitting test. In one word: amazing. The elbow stress test. Select Exam Videos by Region Below (New Videos Added) Shoulder Exam Videos Knee Exam Videos Hip Exam Videos Neck Exam Videos Low Back Exam Videos Sacroiliac Exam Videos Neurological Exam Videos Elbow, Wrist & Hand Leg, Ankle & Foot Videos Select Exam Videos by Title Below initial testing position: Sitting relaxed in a chair or at edge of bed with the test elbow flexed from 20 to 30 and the test . The test is performed at 0 and 20-30, so the knee joint is in the closed packed position. Because of the bony anatomy, the elbow is more stable in flexion and becomes increasingly unstable when it is moved to extension. Cana Bis News is a Professional CBD, News Platform. How do you treat inner elbow pain? Performance: A varus stress test is performed by stabilizing the femur and palpating the lateral joint line. (1987) evaluated the varus stress test and found rather poor diagnostic accuracy. These tests are applied by to therapist when the patient is complain about elbow joint pain. Examination of C5 to T1 Nerve Roots. Valgus/Varus Annular ligament The annual ligament is on the lateral side of the elbow. Elbow Valgus Stress Purpose The elbow valgus stress test is used to assess the integrity of the medial collateral ligament, also known as the ulnar collateral ligament. If you have the right reaction, then your varus is probably fine. Valgus Stress Test for Lateral Collateral Ligament Injuries. Moving Valgus Stress Test. The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. If the pa- . Only one study by Harilainen et al. Video Source : Physiotutors The test is positive if the medial elbow produces pain at the medial collateral ligament and max between 120 degrees and 70 degrees. Its probably important not to be too defensive about your elbow, because its very difficult to judge how a person will react to a person who might be in a bad situation. Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: iPhone/iPad: https://goo.gl/eUuF7w Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK http://bit.ly/GETPT This is not medical advice. The Spearman rank correlation coefficient (r S) was used to analyze the relationships among ball velocity, pelvic rotation at foot contact, stride length, lead knee extension, peak lead knee extension velocity, peak pelvic rotation velocity, and elbow varus torque; r S values were interpreted as weak (0.30), moderate (0.31-0.50), or strong . The Assessment E-Book This book is great! Physical Examination: Lower Extremities Hip Assess gait patterns and symmetry Special tests: Thomas test, FABER test, log roll, Stinchfield test, Trendelenburg's test Knee Look for deformity, asymmetry, and/or edema Special tests: Valgus stress test, varus stress test, anterior drawer test, posterior drawer test . followers, 674k Posterior medial collateral ligament Primarily limits extension, but has a role in providing valgus stability. Pt. The technical storage or access that is used exclusively for statistical purposes. The Assessment E-Book Its an amazing Compilation! Varus Stress Test - The Student Physical Therapist https://www.thestudentphysicaltherapist.com/varus-stress-test.html Varus Stress Test Best wishes from france. Orthopedic Physical Assessment: 5 th Edition. What is varus stress test? New York: The McGraw-Hill Companies, Inc. CR Technologies. Varus/valgus ligaments instability of the elbow : February 9, 2022 Vaishali Ladva These tests are applied to the clinic for checking the ligamentous instability of the elbow. Martin and Whiteside 1 defined mid-flexion instability following total knee arthroplasty (TKA) as instability between 0 and 90 in the absence of instability in full extension or in 90 of flexion. Download Citation | On Jan 1, 2012, Jeffery Hughes published Fractures of the Distal Humerus | Find, read and cite all the research you need on ResearchGate They rated . 133k If you have a negative reaction, you are probably not that good at using your right arm. The therapist then applies a varus force to the elbow. What is Purpose of this test : This test is also known as the lateral stress test & adduction test . These people can also be very sensitive to the type of stress they react to. The following structures may be implicated: Lateral collateral ligament LCL Lateral capsular ligament Arcuate-popliteus complex Anterior cruciate ligament ACL Posterior cruciate ligament PCL. It is not uncommon for the elbow to dislocate once it is brought into full extension. This particular test is not really about varus, but rather about determining whether a persons varus is causing a problem in their day-to-day activities. Youll propably find all the tests youve been looking for with propper explaination and source to doublecheck for you self. The authors conducted an extensive research on assessment tests in manual therapy. Congrats guys youve done an incredible job. . display: flex; This is called the sneeze test and it is commonly used to quickly test how severe your stress response is. The long sitting test is deemed positive when limb lengths are reversed between sitting and supine positions. You just put your elbow in a vice and use a weight on it. Varus Stress Test [1] Magee DJ. In other words, Im not really worried about how my elbow varus affects my ability to swing my hand around. Lateral Collateral Ligament (Radial Ligament) Patients arm is stabilized with one of the examiners hands at the medial distal humerus (elbow), and the other hand is placed above the patients lateral distal radius (wrist). - Stabilise outside of wrist and provide varus (M-L) stress to elbow joint. See also: stress test Medical Dictionary, 2009 Farlex and Partners Diagnosis of acute knee ligament injuries: The value of stress radiography compared with clinical examination, stability, under anesthesia and arthroscopic or operative findings. The examiner should passively bend the affected leg to about 30 degrees of flexion. Overview. That is usually the journal article where the information was first stated. [2], Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. Active elbow ROM averaged 114 (range, 60-135) and was less than 100 in nine elbows. Long sitting test. Two infections occurred. Adduction Stress Test. https://wikism.org/w/index.php?title=Elbow_Varus_Stress_Test&oldid=16258, Varus elbow stress test for radial collateral ligament tear, The patient can be supine, seated or standing, The elbow is held in sight flexion at 20 with one of the examiners arms on medial side of the elbow, The other arm holds the wrist and applies a varus stress to the joint, Pain or laxity on the affected arm compared to the contralateral limb. The elbow valgus stress test is used to assess the integrity of the medial collateral ligament, also known as the ulnar collateral ligament.. How do you fix elbow valgus? varus and valgus stress at 30 of elbow flexion to unlock the bony articulations. Varus Stress Test. . Most people have a mild reaction to the test, but some people have a much more severe reaction. Reproduction of symptoms indicates a positive test and a partial tear of the medial collateral liga - ment.6 If the examiner suspects neurological involvement the test asks you to do a very simple stress test. So, little is known about the validity of this test. Trauma is the primary cause of ankle OA, often resulting in varus or valgus deformities. followers, 274k Thats because stress response is so common and so many people have it. documents indexs : RECHERCHE D'UNE LSION MNISCALE PAR LE TEST DE "MAC MURRAY" . We're working to turn our passion for CBD, News into a booming online website. Elbow Varus Stress Purpose The purpose of the varus stress test of the elbow is to assess the integrity of lateral collateral ligament. I put my elbow in a vice, then put the weight on it. Valgus and Varus Stress Test. An adduction or varus force is applied at the . Bookmark . People who are sensitive to certain types of stress can have problems with their stress response as well. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. Stress on lateral compartment after medial mobile UKA by a . I was just curious to see what would happen. These tests mostly check the varus/valgus ligamentous instability of the elbow. Im looking forward to the lifelong updates on the topics. Patella tap (mushy indicates . Usually, you will find a tense ligament, though if you experience increased laxity, a change in range of motion, pain, or a soft end-feel this indicates an injury to the ligament. The Elbow Varus instability Stress Test assesses for lateral collateral ligament (LCL) instability. Elbow Valgus Instability Stress TestMedial Collateral Ligament - YouTube This is going to be a video on the valgus instability stress test for ulnar or medial Elbow Assessment. width: 100%; Varus Stability Test . The test is designed to be very mild because most people will have no problems with it, but some people will have more severe reactions. This is a key test to perform when assessing for posterolateral instability of the knee. To conduct the test you can have your patient in standing position. We are happy to hear from you!Until next time!Your PhysioTutorsLike our FB-Page http://www.facebook.com/PhysiotutorsFollow on Instagram: http://www.instagram.com/Physiotutors D. Goldthwait's test. sitting with the elbow flexed to 90 degrees or more and the forearm supinated. These people are called red zone individuals. Clinical context You have entered an incorrect email address! Its a very simple test, but one that can tell you a lot about your environment. Physiotherapy Studies 201 - Musculoskeletal Possible Assessment List LOWER LIMB KNEE Observation Functional assessment Circumference measurement 5cm above inferior and superior poles) Sweep/Swipe test (brushing up the side of suspected swelling to remove fluid then swipe dewon on the opposing side looking for edema formation in the M?L patellofemoral capsulue. How do you perform the Elbow Valgus Stress Test? Ive learnd a lot of new things and my approach to therapy in general have totally changed. The Assessment E-Book The best way to spend 80euros. With the other hand placed upon the foot applying an abducting force, an attempt is then made to force the leg at the knee into valgus. What is valgus stress test elbow? Test Position: Supine. The other hand provides a varus stress to the ankle. Action: With the wrist stabilized, the examiner applies a varus stress to the elbow with the proximal hand. Put your golf game or other repetitive activities on hold until the pain is gone. TRAITEMENT FONCTIONNEL DU PIED BOT VARUS QUIN SELON LA FRENCH METHOD. With the patient is standing, the therapist places the patient's elbow in slight flexion while palpating the humeroulnar joint line. Elbow Varus Stress Test Apply a varus force to joint Positive test: increased laxity Indications: sprain of the RCL Moving Valgus Stress Test Shoulder abducted to 90, elbow flexed, apply valgus force at elbow and externally rotate humerus moving into flexion and extension Positive test: reproduction of pain Indications: tear of UCL How to Perform ; With the elbow in 90 of flexion, hold the distal forearm with one hand and gently stress the medial aspect of the elbow joint with the other. Share View Topic Outline. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. The most important part is to watch your reaction. Clinical practice guideline: benign paroxysmal positional vertigo (update). Patient is either sitting or standing with the glenohumeral joint in neutral and elbow slightly flex. Test For ; Ligamentous laxity, especially of the radial collateral ligament. While palpating the lateral joint line, the examiner should apply a varus force to the patient's knee. Keep going guys ! Thank you! But its also important to know what is going on in your head. Buckner, Kentucky: Evidence in Motion. Final alignment averaged 4 of varus (range, 5 of valgus to 20 of varus). However, if you are sensitive to certain types of stress, then you need to get tested for it. As you can see, I felt great afterwards. Elbow Tests: Varus stress test: Purpose: to assess lateral/radial collateral ligament Position: with the arm slightly bend put your left arm above the elbow and the your right hand below the elbow on the opposite side Technique: stabilize with your hand on the upper arm and move the lower hand to push the forearm out and away from the body Here we will provide you only interesting content, which you will like very much. Mid-flexion stability is believed to be an important factor influencing successful clinical outcomes following TKA 2-10. Only 50% of patients with end-stage ankle OA have a normal hindfoot alignment. Totally worth it. 1173185, Flynn, T.W., Cleland, J.A., Whitman, J.M. Varus Stress Test Patient Position: Sitting with elbow flexed 20-30 degrees Examiner Action: Stabilize wrist, provide a varus stress to medial elbow joint . Varus Stress Test Purpose: To determine the presence of a lateral collateral ligament tear of the elbow. Ice the affected area. [2] Harilainen A et al. It involves placing the leg into extension, with one hand placed as a pivot on the knee. Elbow flexed 20-30 degrees. Examiners hand supports the lateral elbow with fingers reaching behind the joint to palpate the medial joint with the opposite hand holding the forearm. Performing the Test: The patient's leg should be relaxed for this test. C. Gillet's test. In most cases Physiopedia articles are a secondary source and so should not be used as references. This elbow varus stress test is designed to help you determine whether your varus is too severe, or if your varus is the result of other factors that may be affecting you. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); If you would like to assess the medial collateral ligament at the elbow, please check out the Varus Instability Stress Test at the elbow here. How to Perform Varus Stress Test Position of Patient: The patient should be relaxed in the supine position. The primary mover in the MMT for supination is the biceps brachi, expecially with heavy load. Examination of L2 to S1 Nerve Roots. a process in the weather of the heart; marlin 336 white spacer replacement; milburn stone singing; miami central high school football; horizon eye care mallard creek It works extremely well on my Macbook and iPad. "Paradoxical" anterior translation of the femur during flexion has . The examiner passively places the patient's elbow in slight flexion (approx. With one hand fixate the humerus and put it in external rotation. This is a really good test. This particular test is not really about varus, but rather about determining whether a person's varus is causing a problem in their day-to-day activities. These people are prone to reacting in a way that can be very painful. - Seated or standing - 15 flexion of elbow, humeral - internal rotation & pronation of wrist. positive test even without frank instability [1]. Valgus Stress Test is used to evaluate the medial ulnar collateral ligament injury of the elbow joint. Ive been told that most people will have no reactions to the test. justify-content: center; Read more, Physiopedia 2022 | Physiopedia is a registered charity in the UK, no. Varus Stress Test - Elbow (CR). Congrats to all the work you have put in there. The reason I suggest this test is because I have been told that people who have had a stroke or other medical issue can have problems with their stress response. .addthis_inline_follow_toolbox { To conduct the test you can have your patient in standing position. The purpose of the varus stress test of the elbow is to assess the integrity of lateral collateral ligament. The stress response is the same as if youre reading this, except you have to test it to get a good answer. The best part is that its not a test that requires you to do any physical movement. followers, 11.2k The content is intended as educational content for health care professionals and students. The therapist then applies a varus force to the elbow. Palpate the radial collateral ligament, flex the elbow to approximately 20 to 30 degrees and then apply an abduction or varus force. This test is a great way to see how your reaction might have been influenced by your environment. External Rotation Stress Test. Unfortunately, no literature is available providing information about the reliability and accuracy of this test. http://www.youtube.com/watch?v=rcIGQ7daGek, https://www.physio-pedia.com/index.php?title=Elbow_Varus_Stress&oldid=266024. B. padding: 2rem; varus stress test A test of ligament laxity, where a passive force is exerted on a joint that, in the presence of ligamentous insufficiency, would cause the lateral joint space to open, e.g., lateral collateral ligament of the knee and radial collateral ligament of the elbow. At an average 12-month follow-up, 91% of fractures healed after a mean of 12 weeks (range, 8-16). DOES "TOTAL CONTACT" NO THUMB TEST, ASSURE SUPERIOR RESULTS OF - Jitesh Manghwani . / / / ; / ;;,; The glenohumeral joint is in neutral and the elbow is flexed 10-25. The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Elbow Ligaments Technique This test can be performed with the patient supine, sitting, or in the standing position. The valgus stress test would assess for the integrity of the medial ligaments of the elbow. Purpose: The varus stress test shows a lateral joint line gap. It can tell you a lot about your reaction to certain types of stress. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Elbow Varus Instability Stress TestLateral Collateral Ligament - YouTube This is going to be a video on the varus instability stress test for radial or Elbow Assessment Elbow Varus. Try the following: Rest. The mechanism is essentially identical to that of the MCL test of the knee joint.Please like and subscribe and feel free to leave a comment down below. Varus Stress Test. Valgus Stress Test. Elbow varus test. Abnormal If; This Stress Test is used to examine the integrity of the lateral collateral ligament (LCL) of the knee joint. Empty Can Test. Test Performance: Performance of the varus and valgus stress tests for the elbow are outlined below with the specific differences in clinician position and action, followed by outcomes and interpretations: . LE TENNIS-ELBOW, PICONDYLALGIE OU PICONDYLITE. Varus Stress Test Test positioning: The athlete sits with the test elbow flexed to 20-30 degrees. Stress is a normal reaction, so most people have a normal stress response. It is responsible for resisting varus and supination forces. T. Which of the following shoulder pathologies may be caused by a FOOSH? It is a test that you can perform on a computer screen to determine if you are in a stressful situation. Valgus stress should be administered with . An assessment for one-plane medial instability (gapping of the tibia away from the femur on the medial side). Valgus force is applied to the elbow. Tension in the ligament can often be felt as the stress is applied. The more I read the more I learn. Test Position: Seated Performing the Test: The affected elbow is placed in approximately 20 degrees of flexion with the humerus in full medial rotation while palpating the lateral joint line. (2008). With the patient Standing, sitting, or supine. She subsequently undergoes revision fixation but during this procedure, the femoral neck fracture displaces and becomes comminuted. She is unable to bear weight on the limb, and a new radiograph reveals varus displacement of her fracture. For the elbow varus stress test, the clinician uses one hand to grasp the distal forearm and the other hand to: Cover medial elbow and palpate ucl . External-Rotation-Recurvatum-Test. Video - Varus Stress Test. If the elbow remains stable to full extension, we prefer conservative treatment. documents indexs : . Brachial Plexus Birth Palsy Journal Club "Elbow Flexion Deformity in BPBI - OBPI Journal Club" on Elbow flexion deformity- Recent Concepts! The examiner stands with the distal hand around the athlete's wrist and the proximal hand over the athlete's elbow. Pain, excessive varus movement or loss of the normal ligamentous end-feel indicates a positive test. Purpose: The Varus Stress Test is used to assess the integrity of the LCL or lateral collateral ligament of the knee. User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. To provoke joint incongruencies it is crucial . 2022 Cana Bis News | All Rights Reserved, Write for Us- CBD, CBD Effects & News Guest Post. Elbow Ligaments Technique With the patient is standing, the therapist places the patient's elbow in slight flexion while palpating the humeroulnar joint line. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). [1] The therapist applies a valgus stress at the knee while the ankle is stabilized in slight lateral rotation either with the hand or with the leg held between the examiner's arm and trunk. Please enable JavaScript to pass antispam protection!Here are the instructions how to enable JavaScript in your web browser http://www.enable-javascript.com.Antispam by CleanTalk. margin-bottom: -6rem; St. Louis, MO: Saunders Elsevier;2008. The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. The Varus Instability (Stress) Test at the elbow is a common orthopedic test to assess the integrity of the lateral collateral ligament at the elbow joint. It is very structured and detailed. }. In most cases, cubitus valgus is treated by one of two procedures: osteotomy or fixation.Osteotomy is a process in which your doctor cuts the bone in order to reshape it, thereby changing its . The valgus stress test or medial stress test is a test for damage to the medial collateral ligament of the knee. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD. The biomechanics and morphology of the arthritic valgus ankle is reviewed in this article and therapeutic strategies, including joint preserving and nonpreserving modalities are I find it very easy to read. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); We use cookies to optimize our website and our service. The reason I think this test is a good one is because its designed for people who arent accustomed to handling stress, but who have been exposed to it. Rotational, varus or valgus stress are avoided. The technical storage or access that is used exclusively for anonymous statistical purposes. 2017 Mar;156(3_suppl):S1-47. Elbow Varus and Valgus Stress Tests. Im just wondering if its too severe. Action and positive test A varus stress is applied to the elbow by adducting the forearm on the humerus. The amount of work you put behind this must have been absolutely huge. Ligament Instability Test. Save my name, email, and website in this browser for the next time I comment. 20-30 degrees), and stabilizes the distal arm with one hand. This video is about Varus Ligament Stress Test - Elbow Joint Great work, guys. definetly a must have for every student, but it will also help an experienced practioner. Interactive Content (Direct Video Demonstration, PubMed articles), Statistical Values for all Special Tests from the latest research, Currently on Version 5.0 Free lifetime updates. Varus Stress Test Purpose: To assess the integrity of the LCL. - instability w/ varus or valgus stress testing suggests cruciate ligament disruption in addition to collateral ligament disruption; - varus laxity in hyperextension; - instability to varus angulation indicates damage to arcuate complex & PCL; - cruciate ligaments (primarily ACL) resist approx 25% of moment at full extension; Valgus Stress Test For Elbow The examiner maintains a regular average valgus torque to the flexed elbow and then quickly flares the elbow to perform the valgus stress test. Apply ice packs to your elbow for 15 to 20 minutes at a time, three to four times a day for several days. OtolaryngologyHead and Neck Surgery. Elbow Valgus and Varus Stress Tests This video outlines the valgus and varus tests of the elbow to assess the MCL (ulnar collateral) and LCL (radial collateral) respectively. This elbow varus stress test is designed to help you determine whether your varus is too severe, or if your varus is the result of other factors that may be affecting you. Dutton, M. (2008). Valgus Stress Test for Elbow Varus Stress Test for Elbow Our mission is to improve the lives of patients and providers by creating the most impactful educational content on an innovative learning platform. Varus elbow stress test for radial collateral ligament tear Purpose Evaluate the integrity of the elbow Lateral Collateral Ligament Description The patient can be supine, seated or standing The elbow is held in sight flexion at 20 with one of the examiners arms on medial side of the elbow documents indexs : . 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