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What is the elbow joint?

Elbow joint is a hinge type of synovial joint and present between the lower end of the humerus bone and upper ends of the radius and ulnar bone. It literally includes two articulations:

  1. Humero-ulnar articulation:
    • It is present between the trochlea of the humerus bone and the trochlear notch of the ulna bone.
  2. Humero-radial articulation:
    • It is present between the capitulum of the humerus bone and the head of the radius bone.

On the surface, the elbow joint which a line of the elbow situated about 2 cm below the line joining the two epicondyles of the humerus bone. The complexity of this elbow joint is furthermore increased by its continuity with the superior (upper) radio-ulnar joint. There are three articulations present in the elbow region, viz.

  1. Humero -ulnar
  2. Humero-radial, and
  3. Superior (proximal) radio-ulnar.

The elbow joint is also known as cubital articulations.

elbow joint

Articular surfaces

  • Upper articular surface: It formed by the capitulum and the trochlea of the lower extremity of the humerus bone.
  • Lower articular surface: It formed by the superior surface of the head of the radius bone and the trochlear notch of the ulna.
  1. Capitulum:
    • It is a rounded hemispherical eminence that possesses a smooth articular surface area only on its anterior and inferior aspects.
  2. Trochlea:
    • It is medial to the capitulum in the bone & bears a resemblance to a pulley. The medial flange of the trochlea which is projects to an inferior (lower) level than its lateral flange.
  3. The trochlear notch of the ulna:
    • It is composed of the upper surface of the coronoid process and the anterior surface of the olecranon process the ulna.
  4. The upper end of radius:
    • It is circular in outline present and slightly depressed area in the center.

Ligaments

  • Capsular ligament (Joint capsule).
  • Medial ligament (Ulnar collateral ligament).
  • Lateral ligament (Radial collateral ligament).

Relations

Anterior:

  • Brachialis muscle.
  • Median nerve.
  • Brachial artery.
  • Tendon of biceps brachii.

Posterior:

  • Tendon of the triceps muscle
  • Anconeus muscle

Medially:

  • Flexor carpi ulnaris
  • Ulnar nerve (posteromedially)
  • Common flexor origin of the muscles of the forearm in anteromedially.

Laterally (posterolateral):

  • Supinator
  • Common extensor origin of muscles of the forearm
  • Extensor carpi radialis brevis muscle

Bursae related to the elbow joint

  • Four important bursae are present in this joint, they are following;
    1. The subtendinous olecranon bursa:
      • It is a small bursa present between the triceps tendon and the upper surface of the olecranon process of the ulnar bone.
    2. The subcutaneous olecranon bursa:
      • It is a large bursa present between the skin area and subcutaneous triangular area on the posterior surface of the olecranon.
    3. Bicipitoradial bursa:
      • It is a small bursa separating the biceps tendon from the smooth or plane anterior part of the radial tuberosity.
    4. A small bursa that separating or dividing the biceps tendon from the oblique cord.

Stability of the elbow joint

  • The pulley-shaped trochlea of the humerus fits correctly into the jaw-like trochlear notch of the ulnar bone.
  • Strong ulnar ligament and radial collateral ligament

Arterial supply

It is supplied by arterial anastomosis around the elbow joint is formed by the branches of the brachial artery, radial, & ulnar arteries.

Nerve supply

By articular branches from:

  • Radial nerve (through its branch to anconeus),
  • Musculocutaneous nerve (through its branch to brachialis),
  • The ulnar nerve, and
  • Median nerve.

Movements of the elbow joint

  • Flexion: (muscle)
    • Brachialis
    • Biceps brachii
    • Brachioradialis
  • Extension: (muscle)
    • Triceps
    • Anconeus

Applied anatomy

  • Elbow effusion.
  • Dislocation of the elbow joint.
  • Nursemaid’s elbow/pulled elbow (subluxation of the head of the radius bone).
  • Golfer’s elbow (medial epicondylitis).
  • Student’s elbow (Miner’s elbow).
  • Nerve entrapments (compressions) around the elbow joint.
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