Estudo anatômico e funcional do complexo ligamentar colateral medial do cotovelo

Marcelo Fernandes Tribst,Darlene Sassi,José Carlos Silva Camargo Filho,Antonio Egydio De Carvalho Junior,Américo Zoppi Filho

doi:10.1590/s1413-78522012000600004

Abstract

OBJECTIVE: To carry out an anatomical study of the medial collateral ligament, an important elbow stabilizer in different degrees of elbow flexion-extension. METHODS: Forty elbows were dissected in order to analyze the functional behavior of the anterior, posterior and transverse ligament bands during valgus stress maneuvers of the elbow in different degrees of flexion and extension. Two groups were determined; in the group GPA the posterior band of the ligament was sectioned initially, then the articular capsule and finally the anterior band; in group GAP this order was reversed. RESULTS: Instability was observed in GPA only in the third stage, when there was a greater mean elbow's opening during the flexion (between 50° and 70°); in GAP, the instability was present since the first stage; the degrees of flexion with greater instability were the same as in group GPA. CONCLUSION: The anterior band of the medial collateral ligament of the elbow is the most important stabilizer of the elbow valgus instability, and its principal action occurs between 50° and 70° of elbow flexion. Level of Evidence III, Diagnostic Studies - Investigating a diagnostic test.

Highlights

With the medial ligamentous complex of the elbow (MCL) intact, even with the valgus maneuver, the medial opening of the elbow remained unaltered during the flexion and extension movement
With the MCL intact, the elbow remained stable; there was no opening between the trochlea and the trochlear notch
The flexion and extension movement was performed without stress, followed by the valgus stress maneuver

Summary

Methods

The study method involved the dissection of 40 elbows from 20 fresh cadavers, with age ranging from 22 to 74 years (average = 57.2 years), 18 of these (90%) male and two (10%) female, with non-traumatic causa mortis, coming from the Death Verification Service of the School of Medicine of Universidade de São Paulo. They were all examined before the dissection and presented cli-. 1. Universidade do Oeste Paulista - Presidente Prudente, SP, Brazil.

Results

Discussion

Conclusion