Elbow joint, determined byhumerusThe distal end is composed of the articular surface of the proximal end of the radius and ulna.Structurally, it includes three joints, which are wrapped together in aArticular capsuleInside.
1. Humeroulnar joint: the trochlear joint formed by the notch of the humeral trochlear and ulnar trochlear.
2. Humeroradial joint: the ball and socket joint formed by the small head of the humerus and the joint concave of the radial head should have three directions of movement, but due to the limitation of the ulna, it cannot do adduction and abduction.
3. Proximal radioulnar joint: cylindrical joint composed of the circular articular surface of the radius and the radial notch of the ulna.
The elbow joint is a typical compound joint. The joint capsule is thin and loose in front and back, and both sides are tense.The ligaments that strengthen joints are:
1. Radial collateral ligament: located outside the elbow joint capsule, it starts from the lateral epicondyle of the humerus and is divided into two bundles. It wraps the radial head from front to back and ends at the front and rear edges of the radial notch of the ulna.
2. Ulnar collateral ligament: in the medial side of the elbow joint capsule, from the medial epicondyle of the humerus, the fibers are fan-shaped and end at the anterior and posterior edges of the ulnar trochlear notch.
3. Annular ligaments of radius: in a circular shape, it surrounds the radial head from the front, rear and lateral sides, and attaches to the front and rear edges of the radial notch of the ulna.
All elbow ligaments do not stop at the radius, thus ensuring that the radius can rotate inward and outward around the vertical axis.From the perspective of the overall movement of the elbow joint, there are two motion axes, that is, flexion and extension movement around the frontal axis. This motion axis is shared by the humeral ulnar joint and the humeral radial joint, and internal and external rotation movement can be made around the vertical axis. This motion axis is shared by the humeral radial joint and the proximal radial ulnar joint.
Arterial network of elbow joint
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Arterial network of elbow jointIt is formed by anastomosing 9 branches of brachial artery, radial artery and ulnar artery before and after the elbow joint.The network developed well on the dorsal side of the joint, and its main anastomosis was 4 places: ① the anastomosis of the radial collateral artery and the radial recurrent artery. ②The anastomosis of the middle collateral artery and the interosseous recurrent artery. ③Anastomosis of the superior ulnar collateral artery, the posterior branch of the inferior ulnar collateral artery and the posterior branch of the ulnar recurrent artery. ④Anastomosis of the anterior branch of the ulnar inferior collateral artery and the anterior branch of the ulnar recurrent artery.
The arterial network of the elbow joint forms a rich collateral circulation around the elbow joint. When the brachial artery is ligated below the point of origin of the deep brachial artery, the blood supply at the distal end of the collateral circulation formed by the arterial network of the elbow joint can still be compensated.[3]
Related diseases and treatment
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1. Elbow joint is one of the most easily dislocated parts in the human body, with an annual incidence of 0.006%~0.008%, of which 49% can be combined with fractures.Because of the special anatomical structure of the elbow joint and the difficulty in treatment, the prognosis of the patients with elbow dislocation combined with radial capitulum fracture and coronary process fracture is still not ideal, even if they are treated timely and effectively by experienced orthopedic clinicians. Therefore, Hotchkis named this specific type of fracture injury "terroristic triad" (TTI)
2. Elbow stiffness is the general term for the loss of elbow movement function caused by various reasons, and these patients will have obvious living disorders.At present, there is no standard treatment for this, but most orthopedic doctors recommend the treatment of open elbow joint release. This operation restores the elbow joint range of motion by releasing the contracture joint capsule, removing heterotopic ossification, and proliferating coronoid process and olecranon tip osteophyte.
Rehabilitative methods: After surgery, the routine orthosis was fixed for three days, and the drainage was removed on the second day after surgery. From the fourth day after surgery, passive activities were started. Within two weeks, only passive flexion and extension activities were carried out every day. The number of times per day was not too much. Generally, about 10 to 15 times were divided into 2 to 3 groups to complete. Each time, the maximum flexion and extension activity arc that the patient could obtain was reached as far as possible, but the taboo was to increase the pain and fear of patients.At night, passive activity is first carried out to the maximum straight position, and then fixed with a straight brace;Suspend the upper limb at 90 ° elbow flexion in the daytime.After 2 weeks, the active activity function exercise was started, but at night, the upright brace was still used until 4 weeks after the operation.After 4 weeks, do daily life training without resistance or gravity.
