Quantifying the Center of Elbow Rotation: Implications for Medial Collateral Ligament Reconstruction.
Adolescent
Adult
Collateral Ligaments
/ physiopathology
Elbow Joint
/ diagnostic imaging
Female
Forearm
/ diagnostic imaging
Humans
Humerus
/ anatomy & histology
Male
Middle Aged
Models, Anatomic
Muscle, Skeletal
/ anatomy & histology
Range of Motion, Articular
Plastic Surgery Procedures
/ methods
Rotation
Tomography, X-Ray Computed
/ methods
Ulna
/ anatomy & histology
Young Adult
MCL
center of rotation
elbow
ligament
medial
reconstruction
Journal
Hand (New York, N.Y.)
ISSN: 1558-9455
Titre abrégé: Hand (N Y)
Pays: United States
ID NLM: 101264149
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
pubmed:
9
12
2017
medline:
3
6
2020
entrez:
9
12
2017
Statut:
ppublish
Résumé
Medial collateral ligament (MCL) reconstruction of the elbow mandates precise characterization of where the centerline of elbow rotation projects onto the medial epicondyle (ME). A muscle-splitting approach allows the flexor-pronator muscles to remain attached to the ME and facilitates visualization of the MCL remnant, the sublime tubercle, and the ulnohumeral joint line. Knowledge of where the centerline of rotation intersects the ME relative to the ulnohumeral joint line may assist the surgeon during placement of the proximal drill hole. Models were created from the computed tomography scans of 29 normal elbows. The centerline of rotation, center of the trochlea, sublime tubercle, and ulnohumeral joint line were identified. Measurements were taken from the ulnohumeral joint line to the center of the trochlea and to the centerline of rotation in the sagittal view and along the course of the MCL. The centerline of rotation intersected the ME in a consistent location. With the elbow flexed 90°, the trochlea center and the centerline of rotation are essentially in line with each other. There are significant differences between the distances from the ulnohumeral joint line to the center of the trochlea and to the centerline of rotation in both the sagittal view and along the course of the MCL. 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.
Sections du résumé
BACKGROUND
Medial collateral ligament (MCL) reconstruction of the elbow mandates precise characterization of where the centerline of elbow rotation projects onto the medial epicondyle (ME). A muscle-splitting approach allows the flexor-pronator muscles to remain attached to the ME and facilitates visualization of the MCL remnant, the sublime tubercle, and the ulnohumeral joint line. Knowledge of where the centerline of rotation intersects the ME relative to the ulnohumeral joint line may assist the surgeon during placement of the proximal drill hole.
METHODS
Models were created from the computed tomography scans of 29 normal elbows. The centerline of rotation, center of the trochlea, sublime tubercle, and ulnohumeral joint line were identified. Measurements were taken from the ulnohumeral joint line to the center of the trochlea and to the centerline of rotation in the sagittal view and along the course of the MCL.
RESULTS
The centerline of rotation intersected the ME in a consistent location. With the elbow flexed 90°, the trochlea center and the centerline of rotation are essentially in line with each other. There are significant differences between the distances from the ulnohumeral joint line to the center of the trochlea and to the centerline of rotation in both the sagittal view and along the course of the MCL.
CONCLUSIONS
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.
Identifiants
pubmed: 29216764
doi: 10.1177/1558944717743599
pmc: PMC6535941
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
402-407Références
J Shoulder Elbow Surg. 2014 Nov;23(11):1618-23
pubmed: 25037064
Am J Sports Med. 1996 Sep-Oct;24(5):575-80
pubmed: 8883675
Am J Sports Med. 2006 Dec;34(12):1926-32
pubmed: 16902233
J Orthop Res. 2000 Mar;18(2):195-202
pubmed: 10815819
Clin Orthop Relat Res. 1980 Jan-Feb;(146):42-52
pubmed: 7371268
J Shoulder Elbow Surg. 1999 Jan-Feb;8(1):6-10
pubmed: 10077788
Clin Orthop Relat Res. 1986 Jul;(208):266-71
pubmed: 3720134
J Hand Surg Am. 1992 Jan;17(1):164-8
pubmed: 1538101
Am J Sports Med. 2004 Jan-Feb;32(1):85-90
pubmed: 14754728
Clin Orthop Relat Res. 1976 Nov-Dec;(121):222-9
pubmed: 991507
J Anat. 1991 Apr;175:203-12
pubmed: 2050566
J Shoulder Elbow Surg. 1994 May;3(3):151-8
pubmed: 22959691
Am J Sports Med. 1998 Sep-Oct;26(5):620-4
pubmed: 9784806
J Shoulder Elbow Surg. 1998 Jul-Aug;7(4):345-51
pubmed: 9752642
Clin Orthop Relat Res. 1991 Oct;(271):170-9
pubmed: 1914292
J Shoulder Elbow Surg. 2007 Sep-Oct;16(5):657-60
pubmed: 17583541
Clin Orthop Relat Res. 1987 May;(218):186-90
pubmed: 3568478
J Bone Joint Surg Am. 1997 Aug;79(8):1223-31
pubmed: 9278083
J Shoulder Elbow Surg. 2002 Jan-Feb;11(1):65-71
pubmed: 11845152
J Orthop Res. 1987;5(3):372-7
pubmed: 3625360
J Shoulder Elbow Surg. 2001 Mar-Apr;10(2):152-7
pubmed: 11307079
J Bone Joint Surg Am. 1986 Oct;68(8):1158-63
pubmed: 3771597
J Bone Joint Surg Am. 1976 Jun;58(4):501-8
pubmed: 1270470
J Am Acad Orthop Surg. 2001 Mar-Apr;9(2):99-113
pubmed: 11281634