15/12/2025
The basic question remains: what is the real cause of symptoms, or predisposing factor and with clinical experience you will probably mention the nervus interosseus posterior and the arcade of Frohse, or all other adverse mechanical interface on tlhe radial nerve pathway.
𝗤𝘂𝗮𝗻𝘁𝗶𝘁𝗮𝘁𝗶𝘃𝗲 𝗮𝗻𝗱 𝗤𝘂𝗮𝗹𝗶𝘁𝗮𝘁𝗶𝘃𝗲 𝗔𝗻𝗮𝗹𝘆𝘀𝗲𝘀 𝗼𝗳 𝘁𝗵𝗲 𝗟𝗮𝘁𝗲𝗿𝗮𝗹 𝗘𝗹𝗯𝗼𝘄
▫️ This post explores an anatomic study by Bernholt et al. focused on the lateral ligamentous complex and extensor tendon origins of the elbow.
▫️ The research was conducted to provide precise, quantitative measurements of these structures relative to bony landmarks, aiding surgeons in the treatment of pathologies like elbow instability and lateral epicondylitis.
❗ 𝗧𝗵𝗲 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗣𝗿𝗼𝗯𝗹𝗲𝗺
▫️ Elbow dislocations are a frequent injury, representing up to 25% of all traumatic elbow injuries, with damage to the lateral ligamentous complex being the primary lesion associated with these events.
▫️ Improper healing can lead to chronic laxity and posterolateral rotary instability, a condition causing pain and functional limitation.
▫️ While the lateral ulnar collateral ligament is crucial for preventing posterolateral rotary instability, the radial collateral ligament and the overlying extensor musculature also play significant roles in stability.
▫️ Despite the frequency of these repairs, previous studies lacked quantitative descriptions of these attachment sites relative to specific bony landmarks.
🔬 𝗦𝘁𝘂𝗱𝘆 𝗠𝗲𝘁𝗵𝗼𝗱𝗼𝗹𝗼𝗴𝘆
▫️ The researchers utilized 10 fresh-frozen, nonpaired human cadaveric elbows, all male, mean age 42.2 years.
▫️ They employed a 3-dimensional coordinate measuring device to map the footprints of ligaments, tendons, and bony landmarks with high precision.
▫️ The measurements were taken with the elbow clamped in full extension and supination.
🔧 𝗞𝗲𝘆 𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀: 𝗟𝗶𝗴𝗮𝗺𝗲𝗻𝘁𝗼𝘂𝘀 𝗔𝗻𝗮𝘁𝗼𝗺𝘆
■ 🔹 Lateral Ulnar Collateral Ligament (LUCL)
▫️ On the humerus, the LUCL footprint was located 7.1 mm anterior and 9.8 mm distal to the lateral epicondyle.
▫️ It was also positioned 8.6 mm proximal to the radiocapitellar joint line.
▫️ On the ulna, the center of the attachment was found near the supinator tubercle, 1.4 mm anterior and 2.4 mm proximal.
▫️ Qualitatively, the LUCL was present in all specimens, though its proximal attachment often blended with the radial collateral ligament, making the distal attachment more distinct.
■ 🔹 Radial Collateral Ligament (RCL)
▫️ The humeral footprint for the radial collateral ligament was found 6.6 mm anterior and 5.6 mm distal to the lateral epicondyle.
■ 🔹 Annular Ligament
▫️ The center of the ulnar attachment for this ligament was located 17.3 mm proximal to the supinator tubercle.
💪 𝗞𝗲𝘆 𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀: 𝗠𝘂𝘀𝗰𝘂𝗹𝗮𝗿 𝗔𝗻𝗮𝘁𝗼𝗺𝘆
■ 🔹 Extensor Carpi Radialis Brevis (ECRB)
▫️ This was the only humeral footprint found to cross the radiocapitellar joint line.
▫️ It extended a mean distance of 5.9 mm distal to the joint line and possessed a robust attachment to the elbow joint capsule.
▫️ This capsular attachment comprised roughly 20.4% of the muscle belly.
■ 🔹 Extensor Digitorum Communis (EDC)
▫️ The EDC fibers were closely associated with the thick fascia of the extensor carpi radialis brevis, running deep to the extensor digitorum communis muscle belly.
🏥 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗜𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀
■ 🔹 Anatomic Reconstruction
▫️ By providing measured distances from clinically relevant landmarks, such as the radiocapitellar joint line, which is easily identified intraoperatively, surgeons can more accurately reproduce the native anatomy during ligament reconstruction.
■ 🔹 Lateral Epicondylitis
▫️ The finding that the extensor carpi radialis brevis has a significant capsular attachment extending distal to the joint line is important for surgeons performing injections or debridement for tennis elbow.
▫️ Understanding this anatomy helps define safe zones for arthroscopic procedures to avoid damaging the lateral ulnar collateral ligament.
⚠️ 𝗟𝗶𝗺𝗶𝘁𝗮𝘁𝗶𝗼𝗻𝘀
▫️ The study was limited by a small sample size of 10 specimens, all of which were male.
▫️ Consequently, the reported distances may vary based on the s*x and stature of the patient, and the study could not assess normal anatomic variants across a broader population.
🖼️ 𝘼𝙣𝙖𝙡𝙤𝙜𝙮
▫️ To understand the importance of this study, imagine trying to hang a heavy picture frame on a wall where specific studs are hidden.
▫️ Before this research, surgeons knew roughly where the studs were based on general knowledge.
▫️ This study acts like a precise stud finder blueprint, giving exact millimeter measurements from visible corners of the room, ensuring the picture is hung exactly where it belongs for maximum stability.
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⚠️Disclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.⚠️
Link to Article 👇
