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Elbow hyperextension of the left arm
2%
42/2304
Left 5th finger passive extension beyond 90°
3%
73/2304
Genu recurvatum of the bilateral knees
8%
183/2304
Excessive supination of the left forearm
86%
1977/2304
Abducted thumb to reach the ipsilateral forearm (thumb-to-forearm test) of the right hand
1%
14/2304
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Excessive supination of the left arm is not listed as part of the Beighton 9-point scoring system for hypermobility. All of the other options are part of this scoring system, and a score of >6 is associated with connective tissue disorders such as Marfan's and Ehlers-Danlos Syndrome. The Level 5 review article by Schenk and Brems notes that generalized ligamentous laxity has been reported in 45% to 75% of patients who have undergone surgery for multidirectional (MDI) shoulder instability. Patients with MDI have pathologic laxity of the glenohumeral joint in more than one direction with at least one of those being inferior. The onset of symptoms is frequently atraumatic, and the chief complaint is often pain more than instability. Patients can experience concomitant recurrent, transient episodes of numbness, tingling, and weakness in the affected extremity. Most patients can be successfully treated nonoperatively with a specific exercise program. If a 6-month trial of nonoperative management fails, then surgical intervention with an inferior capsular shift can be performed.
3.4
(22)
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