Quantifying the Center of Elbow Rotation: Implications for Medial Collateral Ligament Reconstruction

Graham, Kraig S; Golla, Sara; Gehrmann, Sebastian; Kaufmann, Robert A.

doi:10.1177/1558944717743599

Cited by 11 publications

(2 citation statements)

References 25 publications

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“…Elbow flexion and extension occur through the UH and RC joints along an axis of rotation running approximately through the center of the arcs of the trochlea and capitellum. 7,8 Conversely, forearm rotation occurs at the PRUJ along an axis running from the radial head to the ulnar fovea. 9 Whereas up to 50% of the olecranon process can be removed in biomechanical studies without subsequent elbow subluxation, fractures involving the base or anteromedial facet of the coronoid cause progressive elbow instability, often leading to elbow dislocation.…”

Section: Applied Surgical Anatomymentioning

confidence: 99%

Complex Elbow Fracture-Dislocations: An Algorithmic Approach to Treatment

Meyer,

Leversedge,

Catalano

et al. 2024

J Am Acad Orthop Surg

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Elbow stability arises from a combination of bony congruity, static ligamentous and capsular restraints, and dynamic muscular activation. Elbow trauma can disrupt these static and dynamic stabilizers leading to predictable patterns of instability; these patterns are dependent on the mechanism of injury and a progressive failure of anatomic structures. An algorithmic approach to the diagnosis and treatment of complex elbow fracture-dislocation injuries can improve the diagnostic assessment and reconstruction of the bony and ligamentous restraints to restore a stable and functional elbow. Achieving optimal outcomes requires a comprehensive understanding of pertinent local and regional anatomy, the altered mechanics associated with elbow injury, versatility in surgical approaches and fixation methods, and a strategic rehabilitation plan.

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Section: Applied Surgical Anatomymentioning

confidence: 99%

Complex Elbow Fracture-Dislocations: An Algorithmic Approach to Treatment

Meyer,

Leversedge,

Catalano

et al. 2024

J Am Acad Orthop Surg

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“…The center of the each best fitting line were determined to create 11 points to represent a line which defined as the instantaneous rotation axis (Fig. 3C) [20].…”

Section: Image Analysis Determination Of the Rotational Axismentioning

confidence: 99%

The dynamic rotation axis of ulnohumeral joint during active flexion-extension: an in vivo 4-dimensional computed tomography analysis

Liu

Kholinne

Sun

et al. 2022

BMC Musculoskelet Disord

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Background As the collateral ligament reconstruction becomes more common to perform, the knowledge between the collateral ligament reconstruction and the elbow rotation axis is still ambiguous. The purpose of this study was to investigate the location of the intersections between the elbow rotation axis and medial and lateral aspect of the humerus. Methods Four-dimensional computed tomography (4D CT) scan was designed to obtain the images from 8 participants. The instantaneous rotation axis was created according to the trochlea notch of the ulna in the Rapidform XO software. Then the intersections between the instantaneous rotation axis and the medial and lateral aspect of the humerus were identified in the Geomagic Wrap software. Landmark coordinate systems of the distal humerus was created. Result The intersections in the medial aspect of the humerus were mostly located in the superior and posterior quadrant and showed the trend from anterior-superior to posterior-superior with the increment of the elbow flexion. The intersections in the lateral aspect of the humerus were mostly located in the middle half of the anterior quadrant and showed the trend from posterior-inferior to anterior-superior with the increment of the elbow flexion. Conclusion There’s no isometric point for medial collateral ligament (MCL) and lateral ulnar collateral ligament (LUCL) reconstruction. The isometric area for MCL reconstruction should be considered at the superior and posterior quadrant of the medial aspect of the humerus. The isometric area for LUCL reconstruction should be considered at the middle half of the anterior quadrant of the lateral aspect of the humerus. Trial registration This work was supported by the National Natural Science Foundation of China [No.81911540488] in 07/01/2019.

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Evaluating the efficacy of hinged elbow braces in reducing passive valgus forces after ulnar collateral ligament injury—A biomechanical study

Hoffeld,

Wahlers,

Hockmann

et al. 2025

J. exp. orthop.

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PurposeThis biomechanical study aimed to investigate the effectiveness of a hinged elbow orthosis in reducing passive valgus forces following medial ulnar collateral ligament (UCL) injuries of the elbow joint. The hypothesis tested was that a hinged elbow orthosis reduces these passive valgus forces.MethodsEight fresh frozen cadaveric elbow specimens were prepared and tested under three scenarios: intact ligaments, simulated UCL rupture and application of a hinged elbow brace after simulated UCL rupture. Valgus instability was assessed using a custom testing set‐up and the Optotrak motion capture system. Statistical analysis was conducted to compare the results across scenarios.ResultsIntraclass correlation (ICC) calculation showed that the testing set‐up was reliable in investigating valgus deflection across all levels of applied force. The hinged elbow brace reduced passive valgus forces after UCL rupture. The reduction in valgus instability was consistent with close approximation to the native state, although not reaching its level.ConclusionThe hypothesis—that a hinged elbow orthosis significantly reduces passive valgus forces in the elbow following UCL injuries—is not supported by the data and therefore has to be rejected. Nevertheless, the study demonstrates a tendency that a hinged elbow brace could mitigate these forces, at least in an experimental cadaveric model with static study conditions.Level of EvidenceThe level of evidence of this study is level IV.

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Quantifying the Center of Elbow Rotation: Implications for Medial Collateral Ligament Reconstruction

Abstract: The centerline of rotation is located 14.31 mm (1.70) from the ulnohumeral joint line in the sagittal view and 16.54 mm (2.09) from the ulnohumeral joint line along the course of the MCL.

Cited by 11 publications

References 25 publications

Complex Elbow Fracture-Dislocations: An Algorithmic Approach to Treatment

Complex Elbow Fracture-Dislocations: An Algorithmic Approach to Treatment

The dynamic rotation axis of ulnohumeral joint during active flexion-extension: an in vivo 4-dimensional computed tomography analysis

Evaluating the efficacy of hinged elbow braces in reducing passive valgus forces after ulnar collateral ligament injury—A biomechanical study

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