Radiographic Description of Soft Tissue Attachments around the Elbow

Document Type : RESEARCH PAPER


1 Department of Orthopaedic Surgery, Saint Louis University, St. Louis, MO, USA

2 Palm Beach Orthopaedic Institute, Palm Beach Gardens, FL, USA



Objectives: Quantitatively define the radiographic locations of the major soft-tissue attachments about 
the elbow.
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


Main Subjects

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Volume 11, Issue 9
September 2023
Pages 556-564
  • Receive Date: 08 July 2020
  • Revise Date: 17 July 2023
  • Accept Date: 19 July 2023
  • First Publish Date: 19 July 2023