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Osteology
• Consist of
– Humerus

The Elbow Complex – Ulna

– Radius

Anterior aspect

Osteology

Posterior aspect

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Bony Anatomy: Humerus Osteology

Radius Ulna

Joints of Elbow Joints of Elbow

• Humeroradial joint
• Humeroulnar joint
–gliding joint in which the capitellum of
• Humeroradial joint the humerus articulates with the
• Radioulnar joint proximal end of the radius

– Proximal radioulnar joint

– Distal radioulnar joint

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Joints of Elbow
• Humeroulnar joint
–hinge joint in which the humeral
trochlea articulates with the trochlear
fossa of the ulna

Joints of Elbow
• Radioulnar joint
–the proximal and distal radioulnar joints
are pivot joints

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Ligaments of the Elbow

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Lateral Ligamentous Structures Ligaments of the Elbow

• Lateral/radial collateral ligament – origin is near
axis of elbow flexion/extension, so fibers uniformly
tight throughout ROM
• Annular ligament – inserts on anterior/posterior
margins of lesser (radial) semilunar notch, maintains
radial head in contact with ulna (forms 4/5 of fibro-
osseous ring)

Medial Ligamentous Structures

• Medial/Ulnar Collateral
Ligament
– Anterior bundle – most
discrete segment
– Posterior bundle –
thickening of posterior
capsule
– Transverse bundle –
spans medial border of
semilunar notch,
little/no contribution to
elbow stability

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Vascular

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Vascular Nervous Innervation

Median nerve

Ulnar nerve

Radial nerve

Median Nerve Ulnar Nerve

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Range of Motion
• Flexion/extension –
ginglymus joint
(ulnohumeral articulation)
• Flexion typically 0-150
degrees, stops due to soft
tissue approximation
• Extension typically 0-10
degrees (hyperextension,
especially in females), stops
due to bony opposition
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Range of Motion
• Forearm pronation and
supination – trochoid joint
(radiohumeral and proximal
radioulnar articulations)
• Pronation/supination typical
0-85/90 degrees each from
neutral point (thumb up),
stops due to tissue
tensions/stretch from
opposing tissue
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Movements of the Elbow Movements of the Elbow

• Flexion
– Brachialis
– Biceps Brachii
– Brachioradialis

Movements of the Elbow

• Extension
– Triceps Brachii
– Assisted By:
• Anconeus

Brachialis Biceps brachii

Brachioradialis

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Movements of the Elbow

• Pronation
– Pronator teres
– Pronator quadratus

Anconeus

Triceps brachii

Movements of the Elbow

• Pronation
– Flexor group
• Pronator teres
• Flexor carpi radialis
• Flexor digitorum
superficialis
• Flexor digitorum
profundus
• Palmaris longus
• Flexor carpi ulnaris
Pronator quadratus
Pronator teres

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Flexor Digitorum
Flexor Carpi Radialis
Superficialis Palmaris Longus

Flexor Carpi Ulnaris

Flexor Digitorum
Profundus

Movements of the Elbow

• Supination
– Supinator
– Biceps brachii

Biceps brachii
Supinator

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Movements of the Elbow Extensor Carpi

Radialis Longus Extensor Carpi Ulnaris

• Supination
– Extensor group
• Supinator
• Extensor carpi
radialis longus
• Extensor carpi
radialis brevis
• Extensor carpi
ulnaris
• Extensor digitorum Extensor Carpi
Radialis Brevis Extensor
Digitorum

Supination and Pronation Elbow Kinematics

• One of the most congruous and stable
joints
• In extension, anterior capsule provides
most restraint, while MCL becomes
primary stabilizer at 90 degrees flexion
• Annular ligament encircles the head of
the radius, stabilizing it in the radial
notch

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Elbow Kinematics
• Varus stress
– In extension resisted by bone structure, LCL
and lateral joint capsule
– In flexion, resisted primarily by bone
structure
• Valgus stress
– In flexion, resisted primarily by MCL
– In extension equally resisted by bone
structure, MCL and medial joint capsule

Load on the Elbow

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Load on the Elbow
Biomechanics of Elbow Flexors
• Dominant side produces higher flexion
torque, work, and power
• Flexion torques are 70% higher than
extension
• Flexion torques are 20-25% higher in
supinated versus pronated positions due
to increased flexor moment arm of biceps
and brachioradialis
• Max torque at 90°
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Load on the Elbow
Biomechanics of Elbow Extensors
• Generate large and dynamic extensor
torques through high-velocity concentric
and eccentric activities (throw, push)
• Shoulder flexion with pushing activity,
counteracts the tendency of elbow
extensors to extend the shoulder
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