Anatomic relations between the lateral collateral ligament and the radial head: implications for arthroscopic resection of the synovial fold of the elbow.
PURPOSE
The purpose of this study was to determine the anatomic relationship between the radial head and the lateral collateral ligament (LCL) and when the LCL would be at risk of iatrogenic injury during arthroscopic resection of the synovial fold.


METHODS
Thirty-four formalin-fixed upper extremities were dissected. A projection of the LCL onto the radial head was marked with a needle. The percentage of the posterior border of the radial head overlaid by the LCL was digitally measured. A portion of the projection of the LCL was statistically correlated with the overall diameter of the radial head.


RESULTS
The overall diameter of the radial head was 21.2 mm ± 2.3. The proportionate projection of the medial border of the LCL onto the radial head was 5.3 ± 1.6 mm on average. The lateral 25 % of the radial head was overlaid by the LCL with a maximum value of 40 % on average. The inter- and intraobserver reliability showed very good accordance with the digital measurements (r > 0.8).


CONCLUSION
Care must be taken when performing a resection in the lateral 40 % of the radial head, whereas resection in the medial 60 % of the radial head appears to be safe. The LCL is an important stabiliser of the elbow joint, a lesion of which by undeliberate arthroscopic dissection may lead to joint instability. Iatrogenic injury to the LCL presumably can be prevented when respecting the given data.


LEVEL OF EVIDENCE
Experimental study.
['Wegmann|Kilian|K|', 'Burkhart|Klaus Josef|KJ|', 'Bingoel|Alperen Sabri|AS|', 'Ries|Christian|C|', 'Neiss|Wolfram Friedrich|WF|', 'Müller|Lars Peter|LP|']
D000369:Aged, 80 and over D001182:Arthroscopy D002102:Cadaver D017885:Collateral Ligaments D004551:Elbow Joint D005260:Female D006801:Humans D007049:Iatrogenic Disease D007431:Intraoperative Complications D008297:Male D011884:Radius D000074402:Synovectomy
Radial head LCL Elbow joint Anatomy