Abstract
The elbow is a complex anatomical region formed by a multilayered soft-tissue sleeve of muscles, ligaments, and neurovascular structures. The anatomical locations of these structures are unpredictable due to paucity of anatomical landmarks and frequent variations; to add to this variability, dynamic movement at the joint further changes the surface markings for most structures. The layered approach to elbow anatomy is useful during minimally invasive open, endoscopic assisted, and all-endoscopic procedures around the elbow. Each layer is formed by specific muscles and/or ligaments, and neurovascular structures course through or in between these layers from proximal to distal. The distal biceps tendon traverses the layers from superficial to deep planes, and even extends to the posterior aspect in full pronation. The “parabiceps space” is therefore a useful and safe passage across anatomic planes in the lower arm and cubital fossa for elbow endoscopy. Consistent anatomic landmarks across the four layers are useful intraoperative indicators of neurovascular structures in each layer. Lastly, the major nerves are at risk of entrapment during their course, and anatomical structures that predispose to compression must be evaluated and released during surgery.
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Bhatia, D.N. (2022). Elbow Anatomy: A Layered Approach. In: Bhatia, D.N., Bain, G.I., Poehling, G.G., Graves, B.R. (eds) Arthroscopy and Endoscopy of the Elbow, Wrist and Hand. Springer, Cham. https://doi.org/10.1007/978-3-030-79423-1_4
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DOI: https://doi.org/10.1007/978-3-030-79423-1_4
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