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Adam C. Watts - Sports Injuries of the Elbow

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Adam C. Watts Sports Injuries of the Elbow

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Book cover of Sports Injuries of the Elbow Editors Adam C Watts Lennard - photo 1
Book cover of Sports Injuries of the Elbow
Editors
Adam C. Watts , Lennard Funk , Michael Hayton , Chye Yew Ng and Mike Walton
Sports Injuries of the Elbow
1st ed. 2021
Logo of the publisher Editors Adam C Watts Wrightington Hospital Wigan - photo 2
Logo of the publisher
Editors
Adam C. Watts
Wrightington Hospital, Wigan, UK
Lennard Funk
Wrightington Hospital, Wigan, UK
Michael Hayton
Wrightington Hospital, Wigan, UK
Chye Yew Ng
Wrightington Hospital, Wigan, UK
Mike Walton
Wrightington Hospital, Wigan, UK
ISBN 978-3-030-52378-7 e-ISBN 978-3-030-52379-4
https://doi.org/10.1007/978-3-030-52379-4
The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Switzerland AG

The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Contents
James R. A. Smith and Rouin Amirfeyz
James R. A. Smith and Rouin Amirfeyz
Jeppe Vejlgaard Rasmussen and Bo Sanderhoff Olsen
Ann-Maria Byrne and Roger van Riet
Joideep Phadnis and Gregory I. Bain
Christiaan J. A. van Bergen , Kimberly I. M. van den Ende and Denise Eygendaal
Abbas Rashid
Jeremy Granville-Chapman and Adam C. Watts
Philip Holland and Adam C. Watts
Jill L. Thomas and Val Jones
The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021
A. C. Watts et al. (eds.) Sports Injuries of the Elbow https://doi.org/10.1007/978-3-030-52379-4_1
1. Clinical Anatomy of the Elbow
James R. A. Smith
(1)
Severn Deanery, Bristol, UK
(2)
Bristol Royal Infirmary, Bristol, UK
Rouin Amirfeyz (Corresponding author)
Email:
1.1
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1.4
1.5
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Keywords
Elbow Anatomy Bones Ligaments Muscles Nerves Arteries
Key Learning Points
  1. The elbow joint is comprised of three articulations; the humeroulnar, radiocapitellar and proximal radioulnar joints.

  2. The articulations are surrounded buy a joint capsule with condensations that form the lateral ligament complex and medial collateral ligament.

  3. Three important nerves cross the elbow joint; the ulnar nerve, median nerve and radial nerve.

  4. The elbow is supplied by the brachial, radial and ulnar arteries and their recurrent branches. The radial head is intracapsular and relies on retrograde blood flow.

1.1 Introduction

A thorough understanding of the anatomical structures is fundamental to correct diagnosis and safe treatment of disorders of the elbow. This chapter provides an overview of the surgical anatomy, and is divided into four anatomical sections: osteoarticular, capsuloligamentous, muscular and neurovascular.

1.2 Osteoarticular Anatomy

The elbow joint is comprised of three articulations: the humeroulnar , radiocapitellar and proximal radioulnar joints (although located within the capsule of the elbow joint this is really a part of the forearm joint).

1.2.1 The Humerus
The humerus terminates distally as a medial and lateral column, each forming a condyle and an epicondyle. These two columns hold the trochlea and the capitellum. The trochlea is an asymmetrical spool-shaped surface that articulates with the greater sigmoid notch of the olecranon. Its medial aspect projects further distally. The capitellum is hemispherical in shape and articulates with the concave surfaced radial head. The trochlear groove separates the two articular surfaces (Fig. ).
Fig 11 Anterior view of right distal humerus The trochlear-capitellar - photo 3
Fig. 1.1

Anterior view of right distal humerus

The trochlear-capitellar articular surface is internally rotated approximately 57 in relation to the epicondylar axis []. This is an important issue when the joint axis of rotation is to be surgically reproduced (fixation of fracture or application of a dynamic external fixator). In the sagittal plane the articular surface of the humerus protrudes approximately 30 anterior to the long axis of the humerus.

On the anterior surface of the humerus, proximal to the articular surface, lie the coronoid and radial fossae. These accommodate the coronoid process and radial head when the elbow is in full flexion. Similarly, on the posterior aspect of the humerus, the olecranon fossa accommodates the olecranon process of the ulna, permitting full extension of the elbow. The normal range of elbow flexion/extension is approximately 0150, with 30130 necessary to maintain a functional arc [).
Fig 12 Posterior view of right distal humerus 122 The Ulna The main - photo 4
Fig. 1.2

Posterior view of right distal humerus

1.2.2 The Ulna
The main articulating portion of the proximal ulna is the greater sigmoid (or trochlear) notch. It is formed predominantly by the olecranon, with the coronoid process extending the joint surface anteriorly ( Fig. ). It is elliptical in shape, with a longitudinal ridge conveying a stable and congruent articulation with the trochlea, forming the humeroulnar joint. It is oriented approximately 30 posterior to the long axis of the ulna to match the anterior angulation of the distal humerus. The coronoid process is comprised of a large anteromedial facet and smaller anterolateral facet that articulate with the medial trochlea and lateral trochlea respectively.
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