Document Type : RESEARCH PAPER
Department of Orthopaedic Surgery, Saint Louis University, St. Louis, MO, USA
Palm Beach Orthopaedic Institute, Palm Beach Gardens, FL, USA
Objectives: Quantitatively define the radiographic locations of the major soft-tissue attachments about
Methods: In 10 cadaveric elbows, the attachments of the medial ulnar collateral ligament, lateral ulnar collateral
ligament, annular ligament, triceps, and biceps were marked with radiopaque spheres. Measurements were made
on calibrated AP and lateral fluoroscopic images from known osseous landmarks.
Results: On AP radiographs; the anterior bundle of the MUCL (aMUCL) measured 28.6mm (95% CI, 27. 5-29.8mm)
from the humeral attachment to the midpoint of the MUCL ridge on the ulna and 14.3mm, (95% CI 13.0-15.5) to the
olecranon. The LUCL was 39.9mm (95% CI, 38.6 – 41.1mm) from the humeral attachment to the supinator crest
attachment and 8.9mm (95% CI, 8.1-9.8mm) to the lateral epicondyle. On the lateral radiographs, the humeral
attachment of the aMUCL to the medial coronoid was 27.1mm (95% CI, 25.9-28.2mm) and 9.3mm (95%CI, 17.5 -
21.2mm) to the tip. The LUCL humeral attachment to the supinator crest was 45.4mm (95%CI, 44.1-46.8mm). The
LUCL humeral attachment was located 8.9mm (95%CI, 8.0-9.7mm) posterior from the anterior humeral line.
Conclusion: The soft-tissue attachments about the elbow were reproducibly demonstrated on radiographs in
relation to osseous landmarks and radiographic lines. The radiographic relationships will allow for improved
identification of the ligament and tendon attachment sites of the elbow for intraoperative assessment and
postoperative evaluation following reconstruction.
Level of evidence: V