Snapping elbow-A guide to diagnosis and treatment

Table 1 Literature reports on intra-articular snapping elbow

Report and year	No. of patients	Snapping Pathology	Diagnostic procedure	Treatment	Results
Akagi et al[1], 1998	One	Snapping plica	Arthrogram, arthroscopy	Open arthrotomy	Complete recovery
Antuna et al[2], 2001	Fourteen	Snapping plica	MRI, arthroscopic examination	Arthroscopic resection	Ten complete recoveries, two partial recoveries, two failures
Aoki et al[3], 2003	Two	Snapping annular ligament	Arthroscopic examination	One had arthroscopic resection	One complete recovery after resection
Chai et al[4], 2004	One	Snapping annular ligament	Ultrasonography	Arthroscopic resection	Relief of snapping
Fukase et al[13], 2005	One	Snapping plica	Special MRI1	Open resection	Complete recovery
Huang et al[5], 2005	One	Snapping meniscus	MR-arthrography	Arthroscopic resection	Complete recovery
Huang et al[6], 2005	One	Snapping annular ligament	MRI, arthroscopic examination	Arthroscopic resection	Relief of snapping, less pain
Kang et al[7], 2010	Two	Snapping meniscus	MRI, arthrography	Arthroscopic resection	Complete recovery
Maruyama et al[8], 2010	One	Snapping annular ligament	Arthroscopy	Arthroscopic release of the ligament	Complete recovery
Brahe Pedersen et al[9], 2017	Sixtyfour	Hypertrophic synovial plica	Clinical examination and ultrasound	Arthroscopic resection	Significant improvement in Oxford Elbow score after 3 and 22 mo
Shinohara et al[14], 2010	One	Tight fibrous structure	MRI, arthroscopy	Arthroscopic resection	Complete recovery
Steinert et al[10], 2008	Three	Hypertrophic synovial plica	Contrast MRI (in two), arthroscopy	Arthroscopic resection	Complete recovery
Tateishi et al[11], 2005	One	Snapping plica	MRI, arthrogram	Open resection	Complete recovery

¹Special MRI was high-resolution magnetic resonance imaging of the elbow using microscopy coils. MRI: Magnetic resonance imaging; MR: Magnetic resonance.

Table 2 Reports of extra-articular snapping elbow

Report and year	No. of cases	Snapping pathology	Diagnostic procedure	Treatment	Results
Anand et al[16], 2012	One	Snapping ulnar nerve	Open surgery	Transposition of nerve	Complete recovery, returned to elite sport
Cesmebasi et al[35], 2015	Four	Snapping medial antebrachial cutaneous nerve (4), triceps (3) and ulnar nerve (3)	Open surgery/sonography	Open decompression, stabilization or transposition of nerves, resection of tendon	Improvement (mild persistent symptoms to complete recovery)
Chuang et al[17], 2016	One	Snapping triceps and subluxing ulnar nerve	Dynamic sonography	NSAIDs and reduction in repetitive elbow flexion activities at work	Partial improvement
Dreyfuss et al[18], 1978	Two	Snapping triceps	Open reinsertion of the snapping part of the triceps	Reinsertion of the snapping tendon	1 complete recovery, 1 partial
Haws et al[30], 1995	One	Snapping triceps	Open exploration	Open resection of tendon	Complete recovery
Hayashi et al[19], 1984	One	Snapping triceps	Physical examination, radiographs, open surgery	Medial epicondylectomy and division of tendon	Complete recovery
Jacobson et al [20], 2001	Three	Snapping ulnar nerve, snapping triceps	Dynamic sonography	Open “surgical treatment for each abnormality”	Not reported
Lasecki et al[21], 2014	One	Snapping triceps and ulnar nerve	MRI and dynamic sonography	Not reported	Not reported
Minami et al[31], 1999	One	Snapping triceps	Not reported	Open tendon resection	Complete recovery
Reis et al[22], 1980	One	Snapping triceps	Open surgery	Open tendon resection	Complete recovery
Rolfsen[23], 1970	One	Snapping triceps	Open surgery	Open tendon resection	Complete recovery
Spinner et al[32], 2001	One	Snapping triceps	Physical examination	Open tendon Excision	Complete recovery
Spinner et al[24], 1999	Two	Snapping triceps	Physical examination, MRI	Reduction in weight lifting	Symptoms only appeared during weight lifting
Spinner et al[33], 1999	One	Snapping triceps lateral	Palpation and MRI	Open tendon resection	Complete recovery
Spinner et al[25], 2000	Fifteen	Snapping triceps after operation for snapping ulnar nerve	Physical examination, MRI	Lateral transposition or excision of tendon (nine patients), six refused surgery	Complete relief of snapping in surgically treated patients. No relief in non-operated
Watts et al[34], 2009	Three	Snapping triceps	Open exploration	Excision (two), tendon division (one)	Complete recovery
Xarchas et al[26], 2007	Three	Snapping ulnar nerve	Palpation	Anterior nerve transposition (two), NSAIDS and change of job as waitress (one)	Complete recovery after surgery. Not reported for non-surgery

NSAIDs: Non-steroidal anti-inflammatory drugs; MRI: Magnetic resonance imaging.