Elbow Complex
• Elbow complex consists of the elbow joint
(humeroulnar and humeroradial) and the proximal
and distal radioulnar joints
• Elbow joint is a complex joint of hinge variety
• Is a uniaxial diarthrodial joint with 1° freedom of
movement
• Flexion/extension occur in saggital plane around a
coronal axis
• The proximal and distal radio ulnar joints are
linked and function as one unit
• Rotation (pronation and supination) occur in a
transverse plane around a longitudinal axis
Humeroulnar and humeroradial articulations:
Articulating surfaces:
Humerus:
• Hour glass shaped trochlea (humeroulnar)–
torchlear groove, coronoid fossa
• Capitulum (humeroradial) – radial fossa
• Olecranon fossa
Radius:
• Head of radius
• Articulates with the capitulum
Ulna:
• Trochlear notch
• Trochlear ridge
Articulation:
• Articulation between ulna and humerus
occurs primarily as a sliding motion of
trochlear notch of ulna on the trochlea
In extension olecranon process enters the olecranon fossa
In flexion coronoid process reaches the coronoid fossa
• Articulation between radial head and the
capitulum involves sliding of concave radial
head on the convex capitulum
1.In full extension no contact between the capitulum &
radial head
2.During flexion the rim of the radius slides in the
capitulotrochlear groove and in full flexion reaches the
radial fossa
Capsule:
• Humeroulnar and humeroradial and
superior radioulnar joint are enclosed in a
single joint capsule
• Capsule is fairly large loose and weak
anteriorly and posteriorly but ligaments
reinforce side ways
Ligaments:
Medial( ulnar) collateral ligament:
• Consists of three parts anterior ,posterior,
transverse
Lateral(radial)collateral ligament:
Axis of Rotation
• The axis of the joint is relatively fixed and
passes through the center of the trochlea
and the capitulum bisecting the longitudinal
axis of shaft of humerus
Carrying angle :
• In anatomic position, the long axis along the shaft
of the humerus and the long axis of the forearm
form an acute angle medially at the elbow. The
angulation is due to the incongruency of the
articulating surfaces
• It is about 5° in men and 10 - 15° in women
• An increase in the carrying angle is abnormal
Cubitus valgus
• Carrying angle disappears when the arm is
pronated and the elbow is in extension or when the
elbow is fully flexed against the forearm
RANGE OF MOTION : Depends on:
• Type of motion:
• Active ROM is usually less than passive ROM
• This is due to the bulk of the contracting
muscles
• With the forearm supinated active elbow flexion
is 135-145°
• Passive elbow flexion is 150-160°
• Position of the forearm:
• In pronation or mid way between prone and
supination the range of elbow flexion is less as
compared to when the forearm is supinated
• Position of the shoulder:
• Two joint muscles (like biceps and triceps)
which cross shoulder & elbow may become
actively/passively insufficient
• Passive tension in the triceps with shoulder
flexion limits elbow flexion
• Simultaneously the biceps looses tension as it
shortens over both the joints
• Passive tension in the biceps with shoulder
hyperextension limits elbow extension
