Abstract
The elbow is a complex joint that consists of three different articulations: humeroulnar, humeroradial, and proximal radioulnar. During certain activities it can be subjected to significant loads, especially in racquet or throwing sports. The ligamentous complexes of the elbow are involved in the pathoanatomy of throwing athletes or in elbow dislocations and instability. The elbow is crossed by important nerves and vessels for the function of the upper extremity and is the origin of the flexor–pronator and extensor–supinator musculatures of the forearm. A sound knowledge of the elbow anatomy is essential to diagnose and treat elbow sports injuries.
The aim of this chapter is to present a review of the elbow anatomy to assist the surgeon or sports medicine physician in the diagnosis and treatment of the athletic population.
Pau Golano has deceased
References
AAOS (2008) Orthopaedic knowledge update: Shoulder and elbow. AAOS 3, 3rd edn, American Academy of Orthopaedic Surgeons. Rosemont, IL, USA. pp 451–460 and 461–476
Alcid JG, Ahmad CS, Lee TQ (2004) Elbow anatomy and structural biomechanics. Clin Sports Med 23(4):503–517
Armstrong AD, Dunning CE, Faber KJ et al (2002) Single-strand ligament reconstruction of the medial collateral ligament restores valgus elbow stability. J Should Elb Surg 11(1):65–71
Beckett KS, McConnell P, Lagopoulos M et al (2000) Variations in the normal anatomy of the collateral ligaments of the human elbow joint. J Anat 197(3):507–511
Bowers AL, Dines JS, Dines DM et al (2010) Elbow medial ulnar collateral ligament reconstruction: clinical relevance and the docking technique. J Should Elb Surg 19(Suppl 2):110–117
Bozkurt M, Acar HI, Apaydin N et al (2005) The annular ligament: an anatomical study. Am J Sports Med 33(1):114–118
Bryce CD, Armstrong AD (2008) Anatomy and biomechanics of the elbow. Orthop Clin N Am 39(2):141–154
Byram IR, Kim HM, Levine WN et al (2013) Elbow arthroscopic surgery update for sports medicine conditions. Am J Sports Med 41(9):2191–2202
Cage DJ, Abrams RA, Callahan JJ et al (1995) Soft tissue attachments of the ulnar coronoid process: an anatomic study with radiographic correlation. Clin Orthop 320:154–158
Callaway GH, Field LD, Deng XH et al (1997) Biomechanical evaluation of the medial collateral ligament of the elbow. J Bone Joint Surg Am 79(8):1223–1231
Cardasco FA, Parkes JC 2nd (1995) Chapter 17: Overuse injuries of the elbow. In: Nicholas JA, Hershman EB (eds) The upper extremity in sports medicine, 2nd edn. Mosby, Missouri, pp 317–330
Cohen MS, Hastings H 2nd (1997) Rotatory instability of the elbow. The anatomy and role of the lateral stabilizers. J Bone Joint Surg Am 79(2):225–233
Cotten A, Jacobson J, Brossmann J et al (1997) Collateral ligaments of the elbow: conventional MR imaging and MR arthrography with coronal oblique plane and elbow flexion. Radiology 204(3):806–812
Dawson DM, Hallet M, Millender LH (1990) Radial nerve entrapment. In: Dawson DM, Hallet M, Millender LH (eds) Entrapment neuropathies, 2nd edn. Little, Brown, Boston, pp 199–233
Deutch SR, Olsen BS, Jensen SL et al (2003) Ligamentous and capsular restraints to experimental posterior elbow joint dislocation. Scand J Med Sci Sports 13(5):311–316
Dugas JR, Ostrander RV, Cain EL et al (2007) Anatomy of the anterior bundle of the ulnar collateral ligament. J Should Elb Surg 16(5):657–660
Duggan JP Jr, Osadebe UC, Alexander JW et al (2011) The impact of ulnar collateral ligament tear and reconstruction on contact pressures in the lateral compartment of the elbow. J Should Elb Surg 20(2):226–233
Farrow LD, Mahoney AJ, Stefancin JJ et al (2011) Quantitative analysis of the medial ulnar collateral ligament ulnar footprint and its relationship to the ulnar sublime tubercle. Am J Sports Med 39(9):1936–1941
Floris S, Olsen BS, Dalstra M et al (1998) The medial collateral ligament of the elbow joint: anatomy and kinematics. J Should Elb Surg 7(4):345–351
Fuss FK (1991) The ulnar collateral ligament of the human elbow joint: anatomy, function and biomechanics. J Anat 175(Apr):203–212
Fuss FK, Wurzl GH (1991) Radial nerve entrapment at the elbow: surgical anatomy. J Hand Surg [Am] 16(4):742–747
Gong HS, Kim JK, Oh JH et al (2009) A new technique for lateral ulnar collateral ligament reconstruction using the triceps tendon. Tech Hand Upper Extrem Surg 13(1):34–36
Gray H (1918) Gray’s anatomy, 20th edn. Lea & Febiger, New York, pp 321–322
Henry AK (1970) Extensile exposure. E&S Livingstone, Edinburgh, p 94
Hoppenfeld S, DeBoer P (2009) Surgical exposures in orthopaedics: the anatomic approach. Lippincott Williams & Wilkins, Philadelphia, pp 111–147
Hsu SH, Moen TC, Levine WN et al (2012) Physical examination of the athlete’s elbow. Am J Sports Med 40(3):699–708
Jones KJ, Dodson CC, Osbahr DC et al (2012) The docking technique for lateral ulnar collateral ligament reconstruction: Surgical technique and clinical outcomes. J Should Elb Surg 21(3):389–395
Kaplan RE, Lillis KA (2002) Recurrent nursemaid’s elbow (annular ligament displacement): treatment via telephone. Pediatrics 110(1):171–174
King JW, Brelsford HJ, Tullos HS (1969) Analysis of the pitching arm of the professional baseball pitcher. Clin Orthop Relat Res 67:116–123
King G, Morrey BF, An K (1993) Stabilizers of the elbow. J Should Elb Surg 2(3):165–174
King GJ, Dunning CE, Zarzour ZD et al (2002) Single-strand reconstruction of the lateral ulnar collateral ligament restores varus and posterolateral rotatory stability of the elbow. J Should Elb Surg 11(1):60–64
Kotani H, Miki T, Senzoku F et al (1995) Posterior interosseous nerve paralysis with multiple constrictions. J Hand Surg [Am] 20(1):15–17
Lehman RC (2005) Lateral elbow reconstruction using a new fixation technique. Arthroscopy 21(4):503–505
Loh YC, Lam WL, Stanley JK et al (2004) A new clinical test for radial tunnel syndrome: the rule of nine test: a cadaveric study. J Orthop Surg (Hong Kong) 12(1):83–86
Lotem M, Fried A, Levy M et al (1971) Radial palsy following muscular effort. A nerve compression syndrome possibly related to a fibrous arch of the lateral head of the triceps. J Bone Joint Surg (Br) 53(3):500–506
Martin BF (1958) The annular ligament of the superior radio-ulnar joint. J Anat 92(3):473–482
McGraw MA, Kremchek TE, Hooks TR et al (2013) Biomechanical evaluation of the docking plus ulnar collateral ligament reconstruction technique compared with the docking technique. Am J Sports Med 41(2):313–320
Mikuni Y, Chiba S, Tonosaki Y (2013) Topographical anatomy of superficial veins, cutaneous nerves, and arteries at venipuncture sites in the cubital fossa. Anat Sci Int 88(1):46–57
Miyake J, Moritomo H, Masatomi T et al (2012) In vivo and 3-dimensional functional anatomy of the anterior bundle of the medial collateral ligament of the elbow. J Should Elb Surg 21(8):1006–1012
Miyasaka KC (1999) Anatomy of the elbow. Orthop Clin N Am 30(1):1–13
Morrey BF (2012) Reconstruction of the posterior bundle of the medial collateral ligament: a solution for posteromedial olecranon deficiency-a case report. J Should Elb Surg 21(11):e16–e19
Morrey BF, An KN (1983) Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med 11(5):315–319
Morrey BF, An KN (1985) Functional anatomy of the ligaments of the elbow. Clin Orthop 201(Dec):84–90
Morrey BF, An KN (2000) Anatomy of the elbow joint and biomechanics of the elbow. In: Morrey B (ed) The elbow and its disorders. WB Saunders, Philadelphia, pp 13–60
Morrey BF, Askew LJ, Chao EY (1981) A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am 63(6):872–877
Munshi M, Pretterklieber ML, Chung CB et al (2004) Anterior bundle of ulnar collateral ligament: evaluation of anatomic relationships by using MR imaging, MR arthrography, and gross anatomic and histologic analysis. Radiology 231(3):797–803
Novak CB, Mehdian H, von Schroeder HP (2012) Laxity of the ulnar nerve during elbow flexion and extension. J Hand Surg [Am] 37(6):1163–1167
O’Driscoll SW, Morrey BF, An KN (1990) Intraarticular pressure and capacity of the elbow. Arthroscopy 6(2):100–103
O’Driscoll SW, Horii E, Morrey BF, Carmichael SW (1992a) Anatomy of the ulnar part of the lateral collateral ligament of the elbow. Clin Anat 5(4):296–303. DOI: 10.1002/ca.980050406
O’Driscoll SW, Jaloszynski R, Morrey BF et al (1992b) Origin of the medial ulnar collateral ligament. J Hand Surg [Am] 17(1):164–168
O’Driscoll SW, Morrey BF, Korinek S et al (1992c) Elbow subluxation and dislocation: a spectrum of instability. Clin Orthop Relat Res 280:186–197
Ochi N, Ogura T, Hashizume H et al (1999) Anatomic relation between the medial collateral ligament of the elbow and the humero-ulnar joint axis. J Should Elb Surg 8(1):6–10
Olsen BS, Vaesel MT, Søjbjerg JO et al (1996) Lateral collateral ligament of the elbow joint: anatomy and kinematics. J Should Elb Surg 5(2):103–112
Osborne GV (1957) The surgical treatment of tardy ulnar neuritis. J Bone Joint Surg (Br) 39:782
Park MC, Ahmad CS (2004) Dynamic contributions of the flexor-pronator mass to elbow valgus stability. J Bone Joint Surg Am 86(10):2268–2274
Pollock JW, Brownhill J, Ferreira LM et al (2009) Effect of the posterior bundle of the medial collateral ligament on elbow stability. J Hand Surg [Am] 34(1):116–123
Portilla Molina AE, Bour C, Oberlin C et al (1998) The posterior interosseous nerve and the radial tunnel syndrome: an anatomical study. Int Orthop 22(2):102–106
Prasad A, Robertson DD, Sharma GB et al (2003) Elbow: the trochleogingylomoid joint. Semin Musculoskelet Radiol 7(1):19–25
Regan WD, Korinek SL, Morrey BF et al (1991) Biomechanical study of ligaments around the elbow joint. Clin Orthop 271:170–179
Reichel LM, Morales OA (2013) Gross anatomy of the elbow capsule: a cadaveric study. J Hand Surg [Am] 38(1):110–116
Rhyou IH, Park MJ (2011) Dual reconstruction of the radial collateral ligament and lateral ulnar collateral ligament in posterolateral rotator instability of the elbow. Knee Surg Sports Traumatol Arthrosc 19(6):1009–1012
Rosenberg BM, Loebenberg MI (2007) Elbow arthroscopy. Bull NYU Hosp Jt Dis 65(1):43–50
Safran M, Ahmad CS, Elattrache NS (2005) Ulnar collateral ligament of the elbow. Arthroscopy 21(11):1381–1395
Sanal HT, Chen L, Haghighi P et al (2009) Annular ligament of the elbow: MR arthrography appearance with anatomic and histologic correlation. AJR Am J Roentgenol 193(2):122–126
Slullitel MH, Andres GE (2010) New technique of reconstruction for medial elbow instability. Tech Hand Upper Extrem Surg 14(4):266–269
Spinner M, Kaplan EB (1970) The quadrate ligament of the elbow: Its relationship to the stability of the proximal radio-ulnar joint. Acta Orthop Scand 41(6):632–647
Terada N, Yamada H, Toyama Y (2004) The appearance of the lateral ulnar collateral ligament on magnetic resonance imaging. J Should Elb Surg 13(2):214–216
Thompson WH, Jobe FW, Yocum LA et al (2001) Ulnar collateral ligament reconstruction in athletes: muscle splitting approach without transposition of the ulnar nerve. J Should Elb Surg 10(2):152–157
Timmerman LA, Andrews JR (1994) Histology and arthroscopic anatomy of the ulnar collateral ligament of the elbow. Am J Sports Med 22(5):667–673
Van Riet RP, Van Glabbeek F, Neale PG et al (2004) Anatomical considerations of the radius. Clin Anat 17(7):564–569
Zoner CS, Buck FM, Cardoso FN et al (2010) Detailed MRI-anatomic study of the lateral epicondyle of the elbow and its tendinous and ligamentous attachments in cadavers. AJR Am J Roentgenol 195(3):629–636
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Malagelada, F., Dalmau-Pastor, M., Vega, J., Golanó, P. (2014). Elbow Anatomy. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_38-1
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DOI: https://doi.org/10.1007/978-3-642-36801-1_38-1
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