Anatomy and

Biomechanics of
the Elbow
TAUFAN H DEWANGGA
Bones
Ligamentous Structures

 MedialCollateral
Ligament
 Anterior bundle – most
discrete segment
 Posterior bundle – thickening
of posterior capsule
 Transverse bundle –little/no
contribution to elbow stability
 Lateral
Collateral
Ligament
 Annular ligament
 Radial collateral ligament
 Ulnar collateral ligament
Muscles & Neurovascular
4 group 
 Posterior (triceps tendon
+ n.ulnaris)
 Lateral (extensor +
supinator muscle +
n.radialis)
 Anterior (flexor muscle
+ n.medianus)
 Medial (flexor pronator
group)
Muscles & Neurovascular
4 group 
 Posterior (triceps tendon
+ n.ulnaris)
 Lateral (extensor +
supinator muscle +
n.radialis)
 Anterior (flexor muscle
+ n.medianus)
 Medial (flexor pronator
group)
Muscles & Neurovascular
4 group 
 Posterior (triceps tendon
+ n.ulnaris)
 Lateral (extensor +
supinator muscle +
n.radialis)
 Anterior (flexor muscle
+ n.medianus)
 Medial (flexor pronator
group)
Muscles & Neurovascular
4 group 
 Posterior (triceps tendon
+ n.ulnaris)
 Lateral (extensor +
supinator muscle +
n.radialis)
 Anterior (flexor muscle
+ n.medianus)
 Medial (flexor pronator
group)
Cubital Fossa
 Superior border –
imaginary line between
medial/lateral epicondyles
 Medial border – pronator
teres muscle
 Lateral border –
brachioradialis muscle
 Contents – brachial artery
and median nerve
Range of Motion
 –
Flexion/extension
ginglymoid joint
(humeroulnar and
humeroradial
articulation)
 Forearm pronation and supination
– Trochoid joint
(proximal radioulnar
articulations)
Range of Motion
 –
Flexion/extension
ginglymoid joint
(humeroulnar and
humeroradial
articulation)
 Forearm pronation and supination
– Trochoid joint
(proximal radioulnar
articulations)
Range of Motion
 –
Flexion/extension
ginglymoid joint
(humeroulnar and
humeroradial
articulation)
 Forearm pronation and supination
– Trochoid joint
(proximal radioulnar
articulations)
 Range of forearm pronation and
supination vary
- AAOS (1965)  700 pronation, 850
supination
- Steindler (1970)  120 -140 degrees
- Wagner (1977)  710 pronation and 880
supination
- Morrey and co. (1981)  triaxial goniometer
 680 pronation,and 740 supination
Functional Motion of the
Elbow
 Most activity of daily living can be performed within a
much more limited range of elbow motion  1000 of
forearm rotation (500 pronation and 500 supination) and 1000
elbow flexion (arc from 300 to 1300)
 Compensatory motion by shoulder abduction and rotation,
trunk flexion and rotation, and movement of the head
Muscles action during flexion
 Brachialis
 primary flexor of the elbow
 Biceps
 active in flexion only when the forearm supinated or
in the neutral position
 Brachioradialis
 active during rapid flexion movements of the
forearm or when a weight was lifted during a slow
flexion movement
Muscles action during
extension
 Triceps

 primary extensor
 Anconeus muscle

 activeinitiating and maintaining elbow

extension, also stabilizing the elbow
Muscles action during
pronation
 Pronator quadratus

 primary pronator
 Pronator teres

 secondary pronator
 FCR

 accessory pronator
Muscle action during
supination
 Supinator
 primary supinator
 Any supination against resistence  assisted by the biceps
Thank You