Background: A screening of ulnar collateral ligament insufficiency is required for overhead throwers, since secondary\r\npathologic changes result from an increased elbow valgus laxity. We developed a new manual method for assessing\r\nelbow valgus laxity and investigated the reliability of this method and its correlation with ultrasonographic assessment.\r\nMethods: We defined elbow valgus laxity as the difference between the shoulder external rotation angle (ER\r\nangle) measured with the elbow in 90 degrees flexion and that measured with the elbow in extension because ER\r\nangle measured with the elbow in 90 degrees flexion includes elbow valgus laxity and ER angle with the elbow in\r\nextension does not include it. ER angle measurement with the elbow in extension involved the use of a custom\r\narm holder. Three examiners each measured elbow valgus laxity by the new method in 5 healthy volunteers.\r\nIntraobserver and interobserver reliability was evaluated by calculating the intraclass correlation coefficient. We\r\nthen assessed 19 high-school baseball players with no complaints of shoulder or elbow pain. Elbow\r\nultrasonography was performed with a 10-MHz linear transducer with the elbow in 90 degrees flexion, and the\r\nforearm in the neutral position, and the width of the medial joint space at the level of the anterior bundle was\r\nmeasured. Elbow valgus laxity assessed by ultrasonography was defined as the difference between the medial joint\r\nspace width with gravity stress and that without gravity stress. Increased elbow valgus laxity assessed by both our\r\nmethod and ultrasonography was defined as the difference between the laxity of the elbow on the throwing side\r\nand that on the contralateral side. Pearson�s correlation coefficient (r) was calculated to evaluate the relationship\r\nbetween increased elbow valgus laxity obtained by our manual method and that by ultrasonography.\r\nResults: Intraobserver reliability ranged from 0.92 to 0.98, and interobserver reliability was 0.70. The increased\r\nelbow valgus laxity assessed by our method was significantly correlated with that assessed by ultrasonographic\r\nassessment (P = 0.019, r = 0.53).\r\nConclusions: Elbow valgus laxity can be assessed by our method. This method may be useful for screening for\r\ninsufficiency of the ulnar collateral ligament.
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