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Anatomic relations between the lateral collateral ligament and the radial head: implications for arthroscopic resection of the synovial fold of the elbow

  • Elbow
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to determine the anatomic relationship between the radial head and the lateral collateral ligament (LCL) and when the LCL would be at risk of iatrogenic injury during arthroscopic resection of the synovial fold.

Methods

Thirty-four formalin-fixed upper extremities were dissected. A projection of the LCL onto the radial head was marked with a needle. The percentage of the posterior border of the radial head overlaid by the LCL was digitally measured. A portion of the projection of the LCL was statistically correlated with the overall diameter of the radial head.

Results

The overall diameter of the radial head was 21.2 mm ± 2.3. The proportionate projection of the medial border of the LCL onto the radial head was 5.3 ± 1.6 mm on average. The lateral 25 % of the radial head was overlaid by the LCL with a maximum value of 40 % on average. The inter- and intraobserver reliability showed very good accordance with the digital measurements (r > 0.8).

Conclusion

Care must be taken when performing a resection in the lateral 40 % of the radial head, whereas resection in the medial 60 % of the radial head appears to be safe. The LCL is an important stabiliser of the elbow joint, a lesion of which by undeliberate arthroscopic dissection may lead to joint instability. Iatrogenic injury to the LCL presumably can be prevented when respecting the given data.

Level of evidence

Experimental study.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany

    Kilian Wegmann, Klaus Josef Burkhart, Alperen Sabri Bingoel, Christian Ries & Lars Peter Müller

  2. Department for Shoulder Surgery, Rhön-Klinikum, Bad Neustadt, Germany

    Klaus Josef Burkhart

  3. Department of Anatomy I, University of Cologne, Cologne, Germany

    Wolfram Friedrich Neiss

Authors
  1. Kilian Wegmann
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  2. Klaus Josef Burkhart
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  3. Alperen Sabri Bingoel
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  4. Christian Ries
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  5. Wolfram Friedrich Neiss
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  6. Lars Peter Müller
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Corresponding author

Correspondence to Kilian Wegmann.

Additional information

The local Ethical Committee of the University Hospital of Cologne has approved the study (Study number: 12.315).

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Wegmann, K., Burkhart, K.J., Bingoel, A.S. et al. Anatomic relations between the lateral collateral ligament and the radial head: implications for arthroscopic resection of the synovial fold of the elbow. Knee Surg Sports Traumatol Arthrosc 23, 3421–3425 (2015). https://doi.org/10.1007/s00167-014-3091-5

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  • DOI: https://doi.org/10.1007/s00167-014-3091-5

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