Quantitative Analysis of the Medial Ulnar Collateral Ligament Ulnar Footprint and Its Relationship to the Ulnar Sublime Tubercle

Abstract

Injuries to the medial ulnar collateral ligament are common. Published success rates after reconstruction of the medial ulnar collateral ligament are highly variable. The present study illustrates how current reconstruction techniques fail to fully restore the true anatomy of the native ligament. Further studies are needed to investigate this issue.

Effect of Distal Ulnar Collateral Ligament Tear Pattern on Contact Forces and Valgus Stability in the Posteromedial Compartment of the Elbow

“…A medial skin incision was made and the thin, membranous posteromedial capsule was dissected, with care taken not to damage the anterior bundle of the UCL, to gain access to the posteromedial compartment of ulnohumeral articulation. The ulnar insertion of the anterior bundle of the UCL was then measured by use of a digital caliper (accuracy, 0.1 mm) as previously described by Farrow et al 8 Next the distal, middle (50%), and proximal points were marked on each specimen.…”

“…9,13 The UCL footprint on the proximal ulna has been shown to be broader than previously thought, with the UCL insertion extending well beyond the sublime tubercle. 6,8 Rupture of the UCL from this broad ulnar attachment can be complete or partial, with partial rupture from the attachment occurring distally or proximally. Multiple studies have shown that complete rupture of the UCL results in valgus instability and abnormal contact forces in the elbow.…”

Elbow US: Anatomy, Variants, and Scanning Technique

“…The lateral synovial fringe (a synovial plica) is depicted as a triangular hyperechoic structure intervening between the capitellum and the radial head. The common extensor tendons are usually evaluated to assess the severity and extent of tendon abnormality with the potential to guide injection (20)(21)(22)(23)(24)(25)(26). The extensor carpi radialis brevis tendon is always involved, followed by the extensor digitorum communis (17).…”

“…This complex consists of several components: the radial collateral ligament, the lateral ulnar collateral ligament, part of the annular ligament, and sometimes an accessory radial collateral ligament (20)(21)(22)(23)(24)(25)(26). The radial collateral ligament proper is a fan-shaped structure that arises from the anteroinferior aspect of the lateral humeral epicondyle and converges with the fibers of the annular ligament distally (19)(20)(21)(22)(23)(24)(25)(26).…”

“…The contralateral normal elbow may be used for comparison. In children, US may help visualize an increased distance between the radial head and the humeral capitellum, probably due to the impingement of the annular ligament (20)(21)(22)(23)(24)(25)(26). This condition is known as "pulled elbow" and it is due to the annular ligament slipping over the radial head following forceful pronation (28).…”