Operative Techniques in Orthopaedics
Volume 19, Issue 4 , Pages 190-198 , October 2009

Anatomy and Physical Examination of the Elbow

  • Eugene Willis Brabston III, MD

      Affiliations

    • Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH
    • ,
  • James Warner Genuario, MD, MS

      Affiliations

    • Steadman Hawkins Clinic, Denver, CO
    • ,
  • John-Erik Bell, MD

      Affiliations

    • Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH
    • Corresponding Author InformationAddress reprint requests to John-Erik Bell, MD, Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756

References 

  1. Morrey BF. The Elbow and its Disorders. In: Philadelphia, PA: WB Saunders; 1985;p. 7–42
  2. Miyasaka KC. Anatomy of the elbow. Orthop Clin North Am. 1999;30:1–13
  3. Morrey BF. In: Applied Anatomy and Biomechanics of the Elbow Joint. vol 35:St Louis, MO: The American Academy of Orthopaedic Surgeons, The C.V. Mosby; 1986;p. 59–68
  4. Ericson A, Arndt A, Stark A, et al. Variation in the position and orientation of the elbow flexion axis. J Bone Joint Surg Br. 2003;85:538–544
  5. Pitt MJ, Speer DP. Imaging of the elbow with an emphasis on trauma. Radiol Clin North Am. 1990;28:293–305
  6. Jupiter JB, Neff U, Ragazzoni P, et al. Unicondylar fractures of the distal humerus: An operative approach. J Orthop Trauma. 1988;2:102–109
  7. Morrey BF, An NK. Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med. 1983;11:315–319
  8. Hotchkiss RN, Weiland AJ. Valgus stability of the elbow. J Orthop Res. 1987;5:372–377
  9. Boone DC, Azen SP. Normal range of motion of joints in male subjects. J Bone Joint Surg Am. 1979;61:756–759
  10. Closkey RF, Goode JR, Kirschenbaum D, et al. The role of the coronoid process in elbow stability (A biomechanical analysis of axial loading). J Bone Joint Surg Am. 2000;82-A:1749–1753
  11. Hull JR, Owen JR, Fern SE, et al. Role of the coronoid process in varus osteoarticular stability of the elbow. J Shoulder Elbow Surg. 2005;14:441–446
  12. Ablove RH, Moy OJ, Howard C, et al. Ulnar coronoid process anatomy: Possible implications for elbow instability. Clin Orthop Relat Res. 2006;449:259–261
  13. Rahman RK, Levine WM, Ahmad CS. Elbow medial collateral ligament injuries. Curr Rev Musculoskelet Med. 2008;1:197–204
  14. Murray WM, Delp SL, Buchanan TS. Variation of muscle moment arms with elbow and forearm position. J Biomech. 1995;28:513–525
  15. Leonello DT, Galley IJ, Bain GI. Brachialis muscle anatomy (A study in cadavers). J Bone Joint Surg Am. 2007;89:1293–1297
  16. Yamaguchi K, Ramsey ML, Galatz LM. Shoulder and Elbow Arthroplasty. In:  Williams GR editors. Philadelphia, PA: Lippincott Williams & Wilkins; 2005;p. 279–295
  17. Madsen M, Marx R, Millett P, et al. Surgical anatomy of the triceps brachii tendon: Anatomical study and clinical correlation. Am J Sports Med. 2006;34:1839–1843
  18. Baker CL, Plancher KD. Operative Treatment of Elbow Injuries. In: New York, NY: Springer; 2001;p. 1–29
  19. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow (A definition of primary and secondary constraints). Clin Orthop Relat Res. 1991;265:187–195
  20. Hamilton CD, Glousman RE, Jobe FW, et al. Dynamic stability of the elbow: Electromyographic analysis of the flexor pronator group and the extensor group in pitchers with valgus instability. J Shoulder Elbow Surg. 1996;5:347–354
  21. An KN, Hui FC, Morrey BF, et al. Muscles across the elbow joint: A biomechanical analysis. J Biomech. 1981;14:659–669
  22. Udall JH, Fitzpatrick MJ, et al. Effects of flexor-pronator muscle loading on valgus stability of the elbow with an intact, stretched, and resected medial ulnar collateral ligament. J Shoulder Elbow Surg. 2009;18:773–778
  23. Galley SH, Richards RR, O'Driscoll SW. Intraarticular capacity and compliance of stiff and normal elbows. Arthroscopy. 1993;9:9–13
  24. Fuss FK. The ulnar collateral ligament of the human elbow joint (Anatomy, function, and biomechanics). J Anat. 1991;175:203–212
  25. Morrey BF, An K-N. Functional anatomy of the ligaments of the elbow. Clin Orthop. 1985;201:84–90
  26. Jobe FW, Stark H. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986;68:1158–1163
  27. Lynch JR, Waitayawinyu T, Hanel DP, et al. J Hand Surg Am. 2008;33:430–437
  28. Callaway GH, Field LD, Deng XH. Biomechanical evaluation of the medial collateral ligament of the elbow. J Bone Joint Surg Am. 1997;79:1223–1231
  29. Morrey BF, An KN, Chao EYS. Functional evaluation of the elbow. In:  Morrey BF editors. The Elbow and its Disorders. Philadelphia, PA: WB Saunders; 1985;p. 73–91
  30. Ahmad CS, Lee TQ, ElAttrache NS. Biomechanical evaluation of a new ulnar collateral ligament reconstruction technique with interference screw fixation. Am J Sports Med. 2003;31:332–337
  31. Fleisig GS, Andrews JR, Dillman CJ, et al. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995;23:233–239
  32. Morrey BF. Anatomy of the elbow joint. In:  Morrey BF editors. The Elbow and Its Disorders. Philadelphia, PA: WB Saunders; 1985;p. 7–42
  33. King GJ, Morrey BF, An K-N. Stabilizers of the elbow. J Shoulder Elbow Surg. 1993;2:165–174
  34. Dunning CE, Zarzour ZD, Patterson SD, et al. Ligamentous stabilizers against posterolateral rotatory instability of the elbow. J Bone Joint Surg Am. 2001;83-A:1823–1828
  35. Takigawa N, Ryu J, Kish VL, et al. Functional anatomy of the lateral collateral ligament complex of the elbow: Morphology and strain. J Hand Surg Br. 2005;30:143–147
  36. Jebson PJ, Engber WD. Radial tunnel syndrome: Long-term results of surgical decompression. J Hand Surg Am. 1997;22:889–896
  37. von Schroeder HP, Scheker LR. Redefining the “Arcade of Struthers”. J Hand Surg Am. 2003;28:1018–1021
  38. Jean IH, Fairbairn KJ. MR imaging of edematous anconeus epitrochlearis: Another cause of medial elbow pain?. Skeletal Radiol. 2005;34:103–107
  39. Ohara JJ, Stone JH. Ulnar nerve compression at the elbow caused by a prominent medial head of the triceps and an aconeus epitrochlearis muscle. J Hand Surg Br. 1996;21:133–135
  40. Bilge T, Yalaman O, Bilge S, et al. Entrapment neuropathy of the median nerve at the ligament of Struthers. Neurosurgery. 1990;27:787–789
  41. Seitz WH, Matsuoka H, McAdoo J, et al. Acute compression of the median nerve at the elbow by the lacertus fibrosus. J Shoulder Elbow Surg. 2007;16:91–94
  42. Adams JE. Injury to the throwing arm: A study of traumatic changes in the elbow joints of boy baseball players. Calif Med. 1965;102:127–132
  43. Brodgon BG, Crow NE. Little Leaguer's elbow. Am J Roentgenol Radium Ther Nucl Med. 1960;83:671–675
  44. Magee DJ. Orthopaedic Physical Assessment. (ed 2). Philadelphia, PA: WB Saunders; 1997;
  45. Andrews JR, Wilk KE, Satterwhite YE, et al. Physical examination of the throwers elbow. Orthop Sports Phys Ther. 1993;17:296–304
  46. Budoff JE, Nirschl RP. Office examination of the elbow: How provocative tests can clinch the diagnosis. Consultant. 2001;2:509–516
  47. Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63:872–877
  48. Jobe FW, Nuber G. Throwing injuries of the elbow. Clin Sports Med. 1986;5:621–636
  49. Veltri Dm, O'Brien SJ, Field LD, et al: The milking maneuver: A new test to evaluate the MCL of the elbow in the throwing athlete: Paper presented at: 10th Open Meeting of the American Shoulder and Elbow Surgeons Specialty Day, 1994, New Orleans, LA
  50. O'Driscoll SW, Lawton RL, Smith AM. The “moving valgus stress test” for medial collateral ligament tears of the elbow. Am J Sports Med. 2005;33:231–239

PII: S1048-6666(09)00132-3

doi: 10.1053/j.oto.2009.09.013

Operative Techniques in Orthopaedics
Volume 19, Issue 4 , Pages 190-198 , October 2009

Article Tools

* Image Usage & Resolution