MSK – Muskuloskelettale Physiotherapie, Table of Contents MSK – Muskuloskelettale Physiotherapie 2025; 29(04): 203-209DOI: 10.1055/a-2595-4369 Schwerpunkt | Vertiefung | Praxis Die einfache Ellenbogenluxation – Assessment und Rehabilitation Authors Val Jones Recommend Article Abstract Buy Article(opens in new window) Ist eine einfache Ellenbogenluxation diagnostiziert, wird diese zunächst unter Sedierung reponiert. Die meisten Patient*innen können danach konservativ behandelt werden, nur ca. 10% benötigen eine Operation. Die Physiotherapie gliedert sich in beiden Fällen in 3 Phasen, die abhängig von physischen Meilensteinen aufeinander aufbauen. Die Extension wird dabei zunächst auf 60° beschränkt. Eine enge Kommunikation zwischen dem ärztlichen und physiotherapeutischen Team ist für eine erfolgreiche Rehabilitation von größter Bedeutung. Full Text References Literatur 1 Morrey BF, An KN. Stability of the elbow: osseus contraints. J Shoulder Elbow Surg 2005; 14: S174-S178 2 Safran MR, Baillargeon D. Soft-tissue stabilizers of the elbow. J Shoulder Elbow Surg 2005; 14: S179-S185 3 Marinelli A, Graves BR, Bain G. et al. Treatment of elbow instability: state of the art. J ISAKOS 2021; 6: 102-115 4 Capo JT, Collins C, Beutel BG. et al. Three-dimensional analysis of elbow soft tissue footprints and anatomy. J Shoulder Elbow Surg 2014; 23: 1618-1623 5 Stoneback JW, Owens BD, Sykes J. et al. Incidence of elbow dislocations in the United States population. J Bone Joint Surg Am 2012; 94: 240-245 6 Singh J, Elvey MH, Hamoodi Z. et al. Current perspectives on elbow dislocation and instability. Annals of Joint 2020; 6 7 Morrey BF, An KN. Functional anatomy of the ligaments of the elbow. Clin Orthop Relat Res 1985; 201: 84-90 8 Cohen MS, Hastings H. Rotatory instability of the elbow. The anatomy and role of the lateral stabilizers. J Bone Joint Surg Am 1997; 79: 225-233 9 O'Driscoll SW, Jupiter JB, King GJ. et al. The unstable elbow. Instr Course Lect 2001; 50: 89-102 10 An KN, Hui FC, Morrey BF. et al. Muscles across the elbow joint: a biomechanical analysis. J Biomech 1981; 14: 659-669 11 An KN, Kaufman KR, Chao EY. Physiological considerations of muscle force through the elbow joint. J Biomech 1989; 22: 1249-1256 12 Lin F, Kohli N, Perlmutter S. et al. Muscle contribution to elbow joint valgus stability. J Shoulder Elbow Surg 2007; 16: 795-802 13 Park MC, Ahmad CS. Dynamic contributions of the flexor-pronator mass to elbow valgus stability. J Bone Joint Surg Am 2004; 86: 2268-2274 14 Udall JH, Fitzpatrick MJ, McGarry MH. et al. Effects of flexor-pronator muscle loading on valgus stability of the elbow with an intact, stretched, and resected medial ulnar collateral ligament. J Shoulder Elbow Surg 2009; 18: 773-778 15 Kwak JM, Rotman D, Lievano JR. et al. The role of the lateral part of the distal triceps and the anconeus in varus stability of the elbow: a biomechanical study. J Shoulder Elbow Surg 2023; 32: 159-167 16 Dunning CE, Zarzour ZD, Patterson SD. et al. Muscle forces and pronation stabilize the lateral ligament deficient elbow. Clin Orthop Relat Res 2001; 388: 118-124 17 Armstrong AD, Dunning CE, Faber KJ. et al. Rehabilitation of the medial collateral ligament-deficient elbow: an in vitro biomechanical study Rehabilitation des Ellenbogens mit medialem Seitenbanddefekt: eine biomechanische In-vitro-Studie. J Hand Surg Am 2000; 25: 1051-1057 18 O'Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg Am 1991; 73: 440-446 19 O'Driscoll SW, Morrey BF, Korinek S. et al. Elbow Subluxation and Dislocation: A Spectrum of Instability. Clin Orthop Relat Res 1992; 280: 186-197 20 Schreiber JJ, Warren RF, Hotchkiss RN. et al. An online video investigation into the mechanism of elbow dislocation. J Hand Surg Am 38: 488-494 21 Robinson PM, Griffiths E, Watts AC. Simple elbow dislocation. Shoulder Elbow 2017; 9: 195-204 22 Appelboam A, Reuben AD, Benger JR. et al. Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children. BMJ 2008; 337: a2428 23 Pipicelli JG, King GJ. Rehabilitation of elbow. Hand Clin 2020; 36: 511-522 24 Verstuyft L, Caekebeke P, van Riet R. Postoperative rehabilitation in elbow surgery. J Clin Orthop Trauma 2021; 20: 101479 25 van Riet RP. Arthroscopic assessment and management of instability: when and how to do surgery in simple dislocations. In: Bain G, Eygendaal D, van Riet RR, eds. Surgical Techniques for Trauma and Sports Related Injuries of the Elbow. Berlin, Heidelberg: Springer Berlin H; eidelberg: 2020 26 Bernas GA, Ruberte Thiele RA, Kinnaman KA. et al. Defining safe rehabilitation for ulnar collateral ligament reconstruction of the elbow: a biomechanical study. Am J Sports Med 2009; 37: 2392-2400 27 Jones V. Rehabilitation des Sportlerellenbogens. Sportphysio 2022; 10: 18-26 28 Iordens GI, Van Lieshout EM, Schep NW. et al. Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial. Br J Sports Med 2017; 51: 531-538 29 Van Lieshout EM, Iordens GI, Polinder S. et al. Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial. Arch Orthop Trauma Surg 2020; 140: 877-886 30 Wolff AL, Hotchkiss RN. Lateral elbow instability: nonoperative, operative, and postoperative management. J Hand Ther 2006; 19: 238-244 31 Lee AT, Schrumpf MA, Choi D. et al. The influence of gravity on the unstable elbow. J Shoulder Elbow Surg 2013; 22: 81-87 32 Page C, Backus SI, Lenhoff MW. Electromyographic activity in stiff and normal elbows during elbow flexion and extension. J Hand Ther 2003; 16: 5-11 33 Manocha RH, Banayan S, Johnson JA. et al. Overhead arm positioning in the rehabilitation of elbow dislocations: An in vitro biomechanical study. J Hand Ther 2022; 35: 245-253 34 Manocha RH, Kusins JR, Johnson JA. et al. Optimizing the rehabilitation of elbow lateral collateral ligament injuries: A biomechanical study. J Shoulder Elbow Surg 2017; 26: 596-603 35 O'Driscoll SW, Jupiter JB, King GJ. et al. The unstable elbow. J Bone Joint Surg 2000; 82: 724-724 36 Monument MJ, Hart DA, Salo PT. et al. Post-traumatic elbow contractures: targeting neuroinflammatory fibrogenic mechanisms. J Orthop Sci 2013; 18: 869-877 37 Collins DF, Refshauge KM, Todd G. et al. Cutaneous receptors contribute to kinesthesia at the index finger, elbow, and knee. J Neurophysiol 2005; 94: 1699-1706 38 Fuentes CT, Bastian AJ. Where is your arm? Variations in proprioception across space and tasks. J Neurophysiol 2010; 103: 164-171 39 Pearce AJ, Hendy A, Bowen WA. et al. Corticospinal adaptations and strength maintenance in the immobilized arm following 3 weeks unilateral strength training. Scand JMed Sci Sports 2013; 23: 740-748 40 Jayakumar P, Teunis T, Vranceanu AM. et al. Psychosocial factors affecting variation in patient-reported outcomes after elbow fractures. J Shoulder Elbow Surg 2019; 28: 1431-1440 41 Wilk KE, Macrina LC, Cain EL. et al. Rehabilitation of the over- head athlete’s elbow. Sports Health 2012; 4: 404-414 42 Carpenter JE, Blasier RB, Pellizzon GG. The effects of muscle fatigue on shoulder joint position sense. Am J Sports Med 1998; 26: 262-265 43 Ellenbecker TS, Nirschl R, Renstrom P. Current concepts in examination and treatment of elbow tendon injury. Sports Health 2013; 5: 186-194 44 Burkhart TA, Andrews DM. Kinematics, kinetics and muscle activation patterns of the upper extremity during simulated forward falls. J Electromyogr Kinesiol 2013; 23: 688-695 Supplementary Material Supplementary Material Zusatzmaterial(englische Version) (PDF)