Universität zu Köln

Hackl, M., Bercher, M., Wegmann, K., Mueller, L. P. and Dargel, J. (2016). Functional anatomy of the lateral collateral ligament of the elbow. Arch. Orthop. Trauma Surg., 136 (7). S. 1031 - 1038. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Introduction The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. Materials and methods Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry. The insertion types of the lateral ulnar collateral ligament (LUCL) were analyzed and classified. Results The ECU runs parallel to the RCL to dynamically preserve varus stability. The supinator and anconeus muscle fibers coalesce with the LCLC and lengthen during pronation. The anconeus fibers run parallel to the LUCL in full flexion. The LCLC consists of the annular ligament (AL) and the isometric radial collateral ligament (RCL). During elbow flexion, its posterior branches (LUCL) tighten while the anterior branches loosen. When performing a pivot shift test, the loosened LUCL fibers do not fully tighten in full extension. The LUCL inserts along with the AL at the supinator crest. Three different insertion types could be observed. Conclusions The LUCL represents the posterior branch of the RCL rather than a distinct ligament. It is non-isometric and lengthens during elbow flexion. The RCL was found to be of vital importance for neutralization of posterolateral rotatory forces. Pronation of the forearm actively stabilizes the elbow joint as the supinator, anconeus and biceps muscle work in unison to increase posterolateral rotatory stability.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bercher, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dargel, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-271307
DOI:	10.1007/s00402-016-2479-8
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	136
Number:	7
Page Range:	S. 1031 - 1038
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTEROLATERAL ROTATORY INSTABILITY; ANCONEUS MUSCLE; RECONSTRUCTION; COMPLEX; MOTION; JOINT Multiple languages Orthopedics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27130