The elbow complex is designed to provide mobility and stability for the hand. It consists of three joints - the humeroulnar joint between the humerus and ulna, the humeroradial joint between the humerus and radius, and the superior and inferior radioulnar joints. These joints allow for flexion-extension, pronation, and supination movements. The elbow is stabilized by ligaments and muscles like the biceps brachi, triceps, and pronators. Common problems affecting the elbow include tennis elbow, golfer's elbow, nursemaid's elbow, and cubital tunnel syndrome.

1. BIOMECHANICS OF ELBOW
COMPLEX

2. INTRODUCTION
 Elbow complex is designed to serve
hand.
 They provide MOBILITY for Hand in
space by apparent shortening and
Lengthening of upper extremity.
 They provide Stability for skillful and
forceful movements

3. ELBOW JOINT

4. HUMERO ULNAR JOINT
 ARTICULATIONS OF
HUMEROULNAR JOINT
 The articulating surface on
the Humerus is Hour glass
shaped TROCHLEA
 The articulating surface on
Ulna is a semicircular
shaped concave surface
called TROCHLEAR
NOTCH

5. HUMERO RADIAL JOINT
 ARTICULATION OF
HUMERORADIAL JOINT
 The articulating surface on
the Humerus is spherical –
shaped CAPITULUM
 The articulating surface on
the RADIUS is the cup
shaped Radial head
surrounded by a rim

6. ARTICULATIONS OF JOINT
 IN EXTENSION
 The OLECRANON
PROCESS enter the
olecranon fossa in
Humeroulnar Joint
 There is no contact
between the articulating
surfaces in Humeroradial
Joint.

7. ARTICULATIONS OF JOINT
 IN FLEXION
 The Trochlear ridge of Ulna
slides along the Trochlear
groove until the Coronoid
process reaches the
Coronoid fossa in
Humeroulnar joint
 The radial head slides over
capitulum and reaches
Radial fossa in Full Flexion.

8. JOINT CAPSULE
 The Humeroulnar , Humeroradial and Superior
Radioulnar Joint are enclosed in a single Joint
capsule.The capsule is fairly loose .
 Anteriorly, it is attached above coronoid and radial
fossa
 Posteriorly ,it is attached above Olecranon fossa.

9. Joints
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 Elbow moves from 0 degrees of extension to 145 to
150 degrees of flexion

10. Joints
 Radioulnar joint
 Trochoid or pivot-type joint
 Radial head rotates around at
proximal ulna
 Distal radius rotates around
distal ulna
 Annular ligament maintains
radial head in its joint
© 2007 McGraw-Hill Higher Education. All
rights reserved.6-10
From Seeley RR, Stephens TD, Tate P:
Anatomy & physiology, ed 7, New York,
2006, McGraw-Hill; Shier D, Butler J, Lewis
R: hole’s human anatomy & physiology, ed
9, New York, 2002, McGraw-Hill.

11. Joints
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 Radioulnar joint
 Supinate 80 to 90 degrees from neutral
 Pronate 70 to 90 degrees from neutral

12. LIGAMENTS
 MEDIAL COLLATERAL LIGAMENT
Extends from Medial epicondyle of Humerus to
Coronoid and
Olecranon process of Ulna
 LATERAL COLATERAL LIGAMENT
Extends from Lateral Epicondyle of Humerus to
Annular Ligament and Olecranon process.
 ANNULAR LIGAMENT
It encircles the head of Radius

13. LIGAMENTS OF ELBOW

14. Movements of Elbow Joint
 FLEXION-EXTENSION ( 0-140 degree)
 AXIS-------Medio Lateral Axis (Passess through
Trochlea)
 PLANE------Saggital plane
 MUSCLES:
 FLEXORS OF ELBOW
 Biceps Brachi---Powerful flexor when elbow is in
90 degree Flexion.
 Brachialis----Flexor of elbow in all position
 Brachioradialis---Flexor of elbow in midprone
position

15. BICEPS BRACHI

16. EXTENSORS OF ELBOW
 TRICEPS is the powerful
extensor of the Shoulder
 Long head of Triceps
depends on Shoulder
Position
 Medial head of Triceps is
active in unresisted Elbow
extension
 All three Heads of Triceps
are active when heavy
resistance is given to
Extension.

17. Movements
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 Flexion
 movement of forearm to shoulder by
bending the elbow to decrease its
angle
 Extension
 movement of forearm away from
shoulder by straightening the elbow
to increase its angle

18. Movements
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 Pronation
 internal rotary movement of
radius on ulna that results in
hand moving from palm-up
to palm-down position
 Supination
 external rotary movement of
radius on ulna that results in
hand moving from palm-
down to palm-up position

19. CARRYING ANGLE
 The angle formed between the axis of Humerus
and the Longitudinal axis of Forearm
 Normal angle: In MEN=5 degree ,
In WOMEN=10 degree
 The angle is more in Women due to Wider Pelvis
 CUBITUS VALGUS: Increase in Carrying Angle
 CUBITUS VARUS: Decrease in Carrying Angle

20. CARRYING ANGLE

21. SUPERIOR RADIOULNAR
JOINT
 ARTICULATION
 The Radial notch on Ulna articulate with Head of
Radius along with Annular Ligament & Capitulum.
 LIGAMENTS
 Annular Ligament-----circle the head of Radius
and keeps the Ulna together.
 Quadrate Ligament----extends from the Inferior
edge of radial notch to Neck of Radius
 Oblique cord------attached to inferior part of
Radial notch on Ulna to just below Radial
Tuberosity

22. INFERIOR RADIOULNAR
JOINT
 ARTICULATION
 The Ulnar notch of Radius articulates with head
of Ulna along with Articular Disc.
 LIGAMENTS
 Anterior Radio Ulnar Ligament----attached to
anterior aspect just above the Ulnar head to
above Ulnar notch.
 Posterior Radio Ulnar Ligament---attached to
posterior part of Ulnar head to above Ulnar
notch.
 Interosseous Membrane---binds the shaft of
Radius and Ulna together.

23. MUSCLES
 PRONATOR TERES----- helps in Pronation,it
acts in all position of Elbow, helps in Stabilization
of Superio Radio Ulnar Joint. Active during rapid
and resisted Pronation.
 PRONATOR QUADRATUS---- helps in
Pronation in all position of Elbow
 SUPINATOR---------helps in Supination in all
position of Elbow
 BICEPS BRACHI-------- helps in Supination
when Elbow is flexed to 90 degree

24. MOVEMENTS
 Pronation & Supination
 Axis of movement extends from radial head to
Ulnar head
 Pronation and Supination movement is good
when Elbow is Flexed to 90 degree
 In Elbow extended position Pronation is limited
due to passive tension in Biceps Brachi.
Supination is limited due to passive tension in
Interosseous Membrane.

25. Nerves
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 All elbow & radioulnar joints muscles are innervated
from median, musculotaneous, & radial nerves of
brachial plexus

26. Nerves
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 Radial nerve - originates from
C5, C6, C7, & C8
 Triceps brachii
 Brachioradialis
 Supinator (posterior
interosseous nerve)
 Anconeus
 Sensation to posterolateral
arm, forearm, & hand

27. Nerves
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 Median nerve - derived from C6 &
C7
 Pronator teres
 Pronator quadratus (anterior
interosseus nerve)
 Sensation to palmar aspect of hand
& first three phalanges, palmar
aspect of radial side of fourth finger,
dorsal aspect of index & long fingers

28. Nerves
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 Musculotaneous nerve -
branches from C5 & C6
 Biceps brachii
 Brachialis

29. PROBLEMS OF ELBOW
 TENNIS ELBOW or LATERAL EPICONDYLITIS:
 Inflammation at origin of Extensors of Wrist at
Lateral Epicondyle.
 It is caused due to repeated forceful contraction
of Wrist Extensors.
 Extensor carpi radialis brevis is affected
 GOLFER’S ELBOW or MEDIAL
EPICONDYLITIS:
 Inflammation at origin of Flexors of Wrist at
Medial Epicondyle.
 Repetitive contractions of Pronator Teres,Flexor
Carpi Ulnaris

30. PROBLEMS OF ELBOW
 NURSEMAID’S ELBOW or PULLED ELBOW
 In small children the radial head is not fully
developed ,lifting small child up in to by one hand
may cause the RADIAL HEAD to slip out of
Annular Ligament.
 CUBITAL TUNNEL SYNDROME
 Repetitive forceful contractions of Flexor carpi
Ulnaris may compress Ulnar Nerve as it passess
through the cubital tunnel between Medial
Epicondyle of Humerus and Olecranon process of
Ulna.