The medial collateral ligament of the elbow joint: Anatomy and kinematics

• Published in: Journal of shoulder and elbow surgery 1998-07, Vol.7 (4), p.345-351
• Main Authors: Floris, Sarah, Olsen, Bo S, Dalstra, Michel, Søjbjerg, Jens O, Sneppen, Otto
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomechanical Phenomena; Cadaver; Collateral Ligaments - anatomy & histology; Collateral Ligaments - physiology; Elbow Joint - anatomy & histology; Elbow Joint - physiology; Female; Humans; Joint Instability - physiopathology; Male; Middle Aged; Range of Motion, Articular; Reference Values
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/S1058-2746(98)90021-0

Eighteen osteoligamentous elbow joint specimens were included in a study of the medial collateral ligament complex (MCL). The morphologic characteristics of the MCL were examined, and three-dimensional kinematic measurements were taken after selective ligament dissections were performed. On morphologic evaluation the MCL is divided into the anterior bundle and the posterior bundle. The anterior bundle can be divided into anterior and posterior bands. The maximum valgus and internal rotatory instability after transection of the anterior band, 11.7° and 11.2°, respectively, were found at elbow flexions of 30° and 40°. Severance of the entire anterior bundle produced major valgus and internal rotatory laxity through the complete flexion arc of maximal 14.2° and 18.5°, respectively, at 70° and 60° of elbow flexion. Cutting both the posterior band and the posterior bundle resulted in only internal rotatory laxity of maximal 7.2° at 130° of elbow flexion. This study defines the anterior band as the primary constraint to valgus and internal rotatory forces, the posterior band as the secondary, and the posterior bundle as the tertiary constraint. The MCL was observed to be a complex of ligamentous fibers rather than individual bands that stabilizes the joint against valgus and internal rotatory forces.