Archives of Orthopaedic and Trauma Surgery

, Volume 113, Issue 5, pp 265–270 | Cite as

Optimal attachment site for reconstruction of the ulnar collateral ligament

A cadaver study
  • Y. Sasashige
  • M. Ochi
  • Y. Ikuta
Original Article


To determine the isometric points for ulnar collateral ligament (UCL) reconstruction, we performed a kinematic study of 15 cadaver elbows. The margins of the anterior and posterior oblique ligaments of the UCL were measured. Five humeral and three ulnar attachment sites were also selected and grouped in pairs for measurement. The distances from the proximal center of the trochlea to three ulnar points were recorded. Measurements were obtained for pairs of attachment sites for flexion of 0°, 30°, 60°, 90°, and 120°. We found that the anterior margin of the anterior oblique ligament (AOL) tended to lengthen as flexion increased from 0° to 60°, and to shorten as flexion exceeded 60°. The posterior margin tended to lengthen with flexion up to 120°. It therefore appears that the AOL consists of functionally different components that remain taut throughout flexion. In all experiments, the location of the humeral attachment site affected the lengths through 120° of flexion. At flexion of 0°–120°, isometricity was observed in the approximate center of the trochlea, apparently the optimal attachment site. We conclude that conventional ligament reconstruction methods that locate the attachment site in the AOL origin provide inadequately for the isometricity observed in the natural anatomy.


Public Health Posterior Margin Reconstruction Method Anterior Margin Attachment Site 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Arafiles RP (1987) Neglected posterior dislocation of the elbow: a reconstruction operation. J Bone Joint Surg [Br] 69-B:199–202Google Scholar
  2. 2.
    Conway JE, Jobe FW, Glousman RE, Fink M (1992) Medial instability of the elbow in throwing athletes. J Bone Joint Surg [Am] 74-A:67–83Google Scholar
  3. 3.
    Hotchkiss RN, Weiland AJ (1987) Valgus stability of the elbow. J Orthop Res 5:372–377Google Scholar
  4. 4.
    Ikeda A, Ugawa A, Kazihara Y, Hamada N (1988) Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg [Am] 13A:501–509Google Scholar
  5. 5.
    Jobe FW, Stark H, Lombardo SJ (1986) Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg [Am] 68-A:1158–1163Google Scholar
  6. 6.
    Lesin BE, Balfour GW (1986) Acute rupture of the medial collateral ligament of the elbow requiring reconstruction. J Bone Joint Surg [Am] 68-A:1278–1280Google Scholar
  7. 7.
    London JT (1981) Kinematics of the elbow. J Bone Joint Surg [Am] 63-A:529–535Google Scholar
  8. 8.
    Morrey BF, An KN (1983) Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med 11:315–319Google Scholar
  9. 9.
    Morrey BF, An KN (1985) Functional anatomy of the ligaments of the elbow. Clin Orthop 201:84–90Google Scholar
  10. 10.
    Norwood LA, Shook JA, Andrews JR (1981) Acute medial elbow ruptures. Am J Sports Med 9:16–19Google Scholar
  11. 11.
    Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg [Am] 67-A:257–262Google Scholar
  12. 12.
    Regan WD, Korinek SL, Morrey BF, An KN (1991) Biomechanical study of ligaments around the elbow joint. Clin Orthop 271:170–179Google Scholar
  13. 13.
    Schutzer SF, Christen S, Jakob RP (1989) Further observations on the isometricity of the anterior cruciate ligament. An anatomical study using a 6-mm diameter replacement. Clin Orthop 242:247–255Google Scholar
  14. 14.
    Schwab GH, Bennett JB, Woods GW, Tullos HS (1980) Biomechanics of elbow instability: the role of the medial collateral ligament. Clin Orthop 146:42–52Google Scholar
  15. 15.
    Søbjerg JO, Ovesen J, Nielsen S (1987) Experimental elbow instability after transection of the medial collateral ligament. Clin Orthop 218:186–190Google Scholar
  16. 16.
    Tullos HS, Erwin WD, Wood GW, et al (1972) Unusual lesions of the pitching arm. Clin Orthop 88:169–182Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • Y. Sasashige
    • 1
  • M. Ochi
    • 2
  • Y. Ikuta
    • 2
  1. 1.Department of Orthopaedic SurgeryChugoku Rosai General HospitalKure City, HiroshimaJapan
  2. 2.Department of Orthopaedic SurgeryHiroshima University School of MedicineHiroshimaJapan

Personalised recommendations