Limits...
Stability of the elbow joint: relevant anatomy and clinical implications of in vitro biomechanical studies.

de Haan J, Schep NW, Eygendaal D, Kleinrensink GJ, Tuinebreijer WE, den Hartog D - Open Orthop J (2011)

Bottom Line: The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies.The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched.Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery-Traumatology, Westfriesgasthuis, P.O. Box 600, 1620 AR Hoorn, The Netherlands.

ABSTRACT
The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched. Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

No MeSH data available.


Related in: MedlinePlus

Left elbow joint with medial collateral ligaments [20].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3104563&req=5

Figure 3: Left elbow joint with medial collateral ligaments [20].

Mentions: The literature search retrieved 108 studies. Thirty-nine studies examining biomechanics and anatomy of the elbow joint on human anatomic specimen were selected for this review. Studies about biomechanics of the elbow joint often refer to the article by Schwab et al., published in 1980 [15]. This study describes the anatomy of the elbow joint and biomechanics of the medial collateral ligament from the clinical point of view. Many of the author’s insights were later proven to be true in studies on elbow joints of human anatomic specimens. The humeral origin of the medial collateral ligament (MCL) is reported to be located eccentrically with respect to the axis of rotation of the joint. The MCL consists of an anterior bundle, AMCL, posterior bundle or PMCL and a transverse ligament; the last structure does not span the joint and therefore does not contribute to stability. The AMCL is divided in two functional components and is taut throughout the full range of flexion and extension because the components are alternatively tightening throughout this range of motion. The posterior part of the AMCL is taut from 80° flexion to full flexion; in contrast, the anterior part of the AMCL is taut in extension. The AMCL is a stronger ligament than the PMCL and acts as the major medial ligamentous joint stabiliser. According to Schwab’s article, the lateral collateral ligament (LCL) runs from the lateral epicondyle to the annular ligament (AL) without attachments to the ulna, so the lateral ulnar collateral ligament (LUCL) and the accessory lateral ligament were not described. Morrey and An studied the functional anatomy of the ligaments of the elbow in ten fresh-frozen upper extremities and a quantitative dissection and described the collateral ligaments (Fig. 3) [16]. They describe an MCL complex (MCLC) consisting of the separately defined anterior (oblique) bundle (AMCL), a posterior bundle (PMCL) and a transverse segment. The transverse segment runs from the coronoid to the tip of the olecranon, i.e., one part of the ulna to another part of the ulna. It is often not well defined and apparently contributes little to nothing to elbow stability because it originates from and inserts on the ulna. The transverse part of the MCL is also called Cooper’s ligament [17]. The LCLC consists of the AL, radial collateral ligament or MCL, accessory lateral ligament and the LUCL (Fig. 4). The LCL is poorly demarcated and runs from the lateral epicondyle to the annular ligament. The accessory posterior ligament runs from the lateral epicondyle to the crista musculi supinatoris ulnae of the ulna together with the inferior margin of the AL. In five of the ten specimens, the LUCL runs from the lateral epicondyle to the crista m. supinatoris of the ulna. In a later publication, this ratio of 5 to 10 was corrected: it was found in nine of the specimens and, in the tenth, was present but underdeveloped [18]. In this later anatomical study, the LUCL was observed in all 17 examined fresh-frozen elbows [18]. This LUCL was already described in 1958 by Martin as a bundle, but without naming it: “a definite bundle which normally crosses the annular band and gains attachment to the supinator crest, frequently to a special tubercle on that crest” [19].


Stability of the elbow joint: relevant anatomy and clinical implications of in vitro biomechanical studies.

de Haan J, Schep NW, Eygendaal D, Kleinrensink GJ, Tuinebreijer WE, den Hartog D - Open Orthop J (2011)

Left elbow joint with medial collateral ligaments [20].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104563&req=5

Figure 3: Left elbow joint with medial collateral ligaments [20].
Mentions: The literature search retrieved 108 studies. Thirty-nine studies examining biomechanics and anatomy of the elbow joint on human anatomic specimen were selected for this review. Studies about biomechanics of the elbow joint often refer to the article by Schwab et al., published in 1980 [15]. This study describes the anatomy of the elbow joint and biomechanics of the medial collateral ligament from the clinical point of view. Many of the author’s insights were later proven to be true in studies on elbow joints of human anatomic specimens. The humeral origin of the medial collateral ligament (MCL) is reported to be located eccentrically with respect to the axis of rotation of the joint. The MCL consists of an anterior bundle, AMCL, posterior bundle or PMCL and a transverse ligament; the last structure does not span the joint and therefore does not contribute to stability. The AMCL is divided in two functional components and is taut throughout the full range of flexion and extension because the components are alternatively tightening throughout this range of motion. The posterior part of the AMCL is taut from 80° flexion to full flexion; in contrast, the anterior part of the AMCL is taut in extension. The AMCL is a stronger ligament than the PMCL and acts as the major medial ligamentous joint stabiliser. According to Schwab’s article, the lateral collateral ligament (LCL) runs from the lateral epicondyle to the annular ligament (AL) without attachments to the ulna, so the lateral ulnar collateral ligament (LUCL) and the accessory lateral ligament were not described. Morrey and An studied the functional anatomy of the ligaments of the elbow in ten fresh-frozen upper extremities and a quantitative dissection and described the collateral ligaments (Fig. 3) [16]. They describe an MCL complex (MCLC) consisting of the separately defined anterior (oblique) bundle (AMCL), a posterior bundle (PMCL) and a transverse segment. The transverse segment runs from the coronoid to the tip of the olecranon, i.e., one part of the ulna to another part of the ulna. It is often not well defined and apparently contributes little to nothing to elbow stability because it originates from and inserts on the ulna. The transverse part of the MCL is also called Cooper’s ligament [17]. The LCLC consists of the AL, radial collateral ligament or MCL, accessory lateral ligament and the LUCL (Fig. 4). The LCL is poorly demarcated and runs from the lateral epicondyle to the annular ligament. The accessory posterior ligament runs from the lateral epicondyle to the crista musculi supinatoris ulnae of the ulna together with the inferior margin of the AL. In five of the ten specimens, the LUCL runs from the lateral epicondyle to the crista m. supinatoris of the ulna. In a later publication, this ratio of 5 to 10 was corrected: it was found in nine of the specimens and, in the tenth, was present but underdeveloped [18]. In this later anatomical study, the LUCL was observed in all 17 examined fresh-frozen elbows [18]. This LUCL was already described in 1958 by Martin as a bundle, but without naming it: “a definite bundle which normally crosses the annular band and gains attachment to the supinator crest, frequently to a special tubercle on that crest” [19].

Bottom Line: The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies.The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched.Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery-Traumatology, Westfriesgasthuis, P.O. Box 600, 1620 AR Hoorn, The Netherlands.

ABSTRACT
The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched. Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

No MeSH data available.


Related in: MedlinePlus