Distinguishing between septic and aseptic olecranon bursitis can be difficult because the physical and laboratory data overlap. Evidence for the optimum length and route of antibiotic treatment for septic cases also differs. In this review we have presented the current data of offending bacteria, frequency of key physical examination findings, ranges of reported laboratory data, and treatment practices so that clinicians might have a better guide for treatment.

The biceps brachii is one of the most variable muscles in the human body in terms of the number of heads contributing to the muscle. The most common origin of these supernumerary heads is along the humeral shaft. We document a previously unreported point of origin for a supernumerary head. Routine dissection of a 10% formalin fixed upper extremity of a 72 year old Caucasian male, revealed a tricipital biceps brachii muscle. The third head took its origin from the deep investing fascia of the brachialis muscle and inserted onto the tendon of the short head of the biceps brachii. We believe this to be a previously unreported point of origin for a supernumerary head of the biceps brachii muscle. Supernumerary heads become clinically important as they can be a source of confusion for surgeons operating in this region and may be mistaken for soft tissue tumors when they are unilateral. An understanding of such variations is important.Keywords: biceps third head; elbow; shoulder; supernumerary biceps brachii Anatomy 2015;9(2):94-99

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Introduction. The purpose of this study is to describe the inner synovial membrane (SM) of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL) was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%), an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release.

The pre-contoured olecranon plate provides adequate fixation to withstand physiologic force in a composite bone and cadaveric comminuted olecranon fracture model.