Elbow anatomy in perspective of joint capsule and surrounding aponeuroses: a narrative review

Background Because of the proximity of several ligaments, aponeuroses, and capsule in the limited area of elbow joint, the precise anatomy is difficult to understand. In the current narrative review, we focused on two anatomical perspectives: the capsular attachment, and structures consisting of ligaments. Methods Based on the previously performed studies regarding the elbow anatomy, a narrative review was prepared in terms of the capsular attachment and structures consisting of ligaments. Results At the tip of the coronoid process, the joint capsule attaches roughly 6 mm distal to its tip with 6-12mm length. On the lateral epicondyle of humerus, the capsular attachment at the anterior part of the extensor carpi radialis brevis origin is narrower than one distal to it. A single interpretation of the lateral collateral ligament is the capsulo-aponeurotic membrane, which is composed of the joint capsule intermingling with supinator aponeurosis. The anterior bundle of ulnar collateral ligament could be interpreted as the grossly separated collagenous structure from the tendinous complex which is composed of the tendinous septum between the flexor digitorum superficialis (FDS) and pronator teres muscles, medial part of brachialis muscle, and deep aponeurosis of FDS muscle. Conclusion Based on these perspectives, ligaments could function as a “static-dynamic” stabilizer rather than a simple static one.