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Elbow extension as a ‘rule-out’ tool for significant injury

Report by: Adam Reuben and Andrew Appelboam, Consultant emergency physicians

Search checked by: Gavin Lloyd, Consultant emergency physician

Institution: Devon and Exeter Foundation NHS Trust, Exeter, Devon, UK

Clinical scenario

A 35-year-old man presents to the emergency department complaining of pain in his left elbow, having fallen onto his outstretched hand. On examination he can fully extend the elbow on the affected side. You have heard that full elbow extension can be used as a ‘rule-out’ tool for significant injury and you wonder whether there is any value in obtaining an x-ray.

Three-part question

In (adults with elbow injuries) does (the ability to fully extend the injured limb) exclude the possibility of (significant injury)?

Search strategy

Ovid MEDLINE from 1950 to July week 2 2010. …

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