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The elbow is a hinge joint that connects the humerus bone of the upper arm to the radius and ulna bones of the lower arm through a complicated system of muscles, ligaments, and tendons. Elbow injuries come in many forms and can unfavorably affect people of all ages and lifestyles. To read more about elbow contions, click here.

Elbow

At OrthoNorcal Orthopedic Specialists, our specialty-trained and experienced elbow surgeons are recognized as leaders in the diagnosis and treatment of elbow injuries and conditions. Frequent surgical procedures our elbow surgeons perform include cubital tunnel release (for cubital tunnel syndrome), elbow replacement, total elbow arthroplasty, medial epicondyletcomy (golfer’s elbow), lateral epicondylitis debridement (tennis elbow), elbow ligament reconstruction, ulnar nerve transposition, and osteochondritis dissecans.

  • Revision Elbow Replacement

    Revision elbow replacement is a surgery performed to replace a loose or worn out initial elbow replacement. Typically, cemented semi-constrained prostheses are used for revision elbow replacement.

  • Tennis Elbow Surgery

    Tennis elbow is a common name for the elbow condition lateral epicondylitis. It is an overuse injury that causes inflammation and microtears of the tendons that attach to the lateral epicondyle.

  • Distal Biceps Repair

    The biceps is a large muscle located in the front of your upper arm and runs from the shoulder to the elbow joint. It is attached to the bones of the shoulder and elbow by tendons.

  • Elbow Ligament Reconstruction

    Ligament reconstruction is considered in patients with ligament rupture. Your surgeon will make an incision over the elbow. Care is taken to move muscles, tendons, and nerves out of the way.

  • Elbow Tendon and Ligament Repair

    The common conditions affecting the tendons around the elbow joint include tennis elbow and golfer’s elbow, which result from an overuse injury to the tendons in weight lifting, or from repetitive activities during sports or occupation.

  • Ulnar Nerve Release

    Ulnar nerve release, also known as ulnar nerve decompression, is a surgical procedure to treat a medical condition called ulnar nerve entrapment.

  • Cubital Tunnel Release (Medial Epicondylectomy)

    Cubital tunnel syndrome is a condition characterized by compression of the ulnar nerve in an area of the elbow called the cubital tunnel.

  • Golfer's Elbow Surgery

    Golfer’s elbow is a condition associated with pain on the inside of the elbow where tendons of your forearm attach to the bony prominence (medial epicondyle). It is also called medial epicondylitis and is caused by injury or irritation to the tendons which can become painful and swollen.

  • Open Elbow Surgery

    Open elbow surgery is an operative procedure performed to treat certain conditions of your elbow through a large, open cut (incision) in the skin using a scalpel.

  • UCL Reconstruction (Tommy John Surgery)

    Commonly called Tommy John surgery, this procedure involves reconstructing a damaged ligament on the inside of the elbow called the ulnar or medial collateral ligament with a tendon graft obtained from your own body or a donor.

  • Malunion Surgery (Elbow)

    Malunion, also known as crooked healing, is the failure of a fractured bone to rejoin properly due to poor alignment of the fracture fragments.

  • Elbow Fracture Reconstruction

    Elbow fracture reconstruction is a surgical procedure employed to repair and restore the appearance and full function of a damaged elbow caused by severe trauma or injury.

  • Radial Head ORIF and Replacement

    Open reduction and internal fixation (ORIF) of the radial head is a surgical technique employed for the treatment of a radial head fracture to restore normal anatomy and improve range of motion and function.

  • Ulnar Nerve Transposition

    The ulnar nerve is one of the 3 main nerves in the arm that travels down from the neck through a bony protuberance inside the elbow (medial epicondyle), under the muscles of the forearm and down the hand on the side of the palm, towards the little finger.

  • Ulnar Collateral Ligament (UCL) Repair with Internal Brace

    UCL repair with an internal brace is a surgery that involves the use of collagen-coated tape (internal brace) surgically placed at the site of the damaged UCL ligaments.

  • Elbow Fusion Surgery

    Fusion eliminates pain by allowing the bones of the joint to grow together, or fuse, into one solid bone. Fusions were very common before effective artificial joints were available and are still performed.

The elbow is a complex joint formed by the articulation of three bones – the humerus, radius, and ulna. The elbow joint helps in bending or straightening of the arm to 180 degrees and lifting or moving objects.

The bones of the elbow are supported by:

  • Ligaments and tendons
  • Muscles
  • Nerves
  • Blood vessels

Bones and Joints of the Elbow

The elbow joint is formed at the junction of three bones:

  • The humerus (upper arm bone) forms the upper portion of the joint. The lower end of the humerus divides into two bony protrusions known as the medial and lateral epicondyles, which can be felt on either side of the elbow joint.
  • The ulna is the larger bone of the forearm located on the inner surface of the joint. It articulates with the humerus.
  • The radius is the smaller bone of the forearm situated on the outer surface of the joint. The head of the radius is circular and hollow, which allows movement with the humerus. The articulation between the ulna and radius helps the forearm to rotate.

The elbow consists of three joints, namely:

  • The humeroulnar joint is formed between the humerus and ulna and allows flexion and extension of the arm.
  • The humeroradial joint is formed between the radius and humerus and allows movements like flexion, extension, supination, and pronation.
  • The radioulnar joint is formed between the ulna and radius bones and allows rotation of the lower arm.

Articular cartilage lines the articulating regions of the humerus, radius, and ulna. It is a thin, tough, flexible and slippery surface that acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated with synovial fluid, which further enables the smooth movement of the bones.

Muscles of the Elbow Joint

There are several muscles extending across the elbow joint that help in various movements. These include the following:

  • Biceps brachii: Upper arm muscle, enabling flexion of the arm
  • Triceps brachii: Muscle in the back of the upper arm that extends the arm and fixes the elbow during fine movements
  • Brachialis: Upper arm muscle beneath the biceps, which flexes the elbow towards the body
  • Brachioradialis: Forearm muscle that flexes, straightens and pulls the arm at the elbow
  • Pronator teres: Muscle that extends from the humeral head, across the elbow, and towards the ulna, and helps to turn the palm facing backward
  • Extensor carpi radialis brevis: Forearm muscle that helps in movement of the hand
  • Extensor digitorum: Forearm muscle that helps in movement of the fingers

Ligaments and Tendons of the Elbow

The elbow joint is supported by ligaments and tendons, which provide stability to the joint.

Ligaments are a group of firm tissues that connect bones to other bones. The most important ligaments of the elbow joint are the:

  • Medial or ulnar collateral ligament: Comprised of triangular bands of tissue on the inner side of the elbow joint
  • Lateral or radial collateral ligament: A thin band of tissue on the outer side of the elbow joint
  • Annular ligament: Group of fibers that surround the radial head, and hold the ulna and radius tightly in place during movement of the arm

Together, the medial and lateral ligaments are the main source of stability and hold the humerus and ulna tightly in place during movement of the arm.

The ligaments around a joint combine to form a joint capsule that contains synovial fluid.

Any injury to these ligaments can lead to instability of the elbow joint.

Tendons are bands of connective tissue fibers that connect muscle to bone. The various tendons that surround the elbow joint include:

  • Biceps tendon: attaches the biceps muscle to the radius, allowing the elbow to bend
  • Triceps tendon: attaches the triceps muscle to the ulna, allowing the elbow to straighten

Nerves of the Elbow

The main nerves of the elbow joint are the ulnar, radial and median nerves. These nerves transfer signals from the brain to the muscles that aid in elbow movements. They also carry sensory signals such as touch, pain, and temperature back to the brain.

Any injury or damage to these nerves causes pain, weakness or joint instability.

Blood Vessels Supplying the Elbow

Arteries are blood vessels that carry oxygen-pure blood from the heart to the hand. The main artery of the elbow is the brachial artery that travels across the inside of the elbow and divides into two small branches below the elbow to form the ulnar and the radial artery.

  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics
  • North American Spine Society
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