title: Anatomic relations between the lateral collateral ligament and the radial head: implications for arthroscopic resection of the synovial fold of the elbow.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Experimental study.
authors.affiliation: Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany. kilian.wegmann@uk-koeln.de.
authors.forename: Kilian
authors.initials: K
authors.lastname: Wegmann
authors.affiliation: Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany.|Department for Shoulder Surgery, Rhön-Klinikum, Bad Neustadt, Germany.
authors.forename: Klaus Josef
authors.initials: KJ
authors.lastname: Burkhart
authors.affiliation: Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany.
authors.forename: Alperen Sabri
authors.initials: AS
authors.lastname: Bingoel
authors.affiliation: Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Ries
authors.affiliation: Department of Anatomy I, University of Cologne, Cologne, Germany.
authors.forename: Wolfram Friedrich
authors.initials: WF
authors.lastname: Neiss
authors.affiliation: Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany.
authors.forename: Lars Peter
authors.initials: LP
authors.lastname: Müller
mesh_terms: D000369:Aged, 80 and over; D001182:Arthroscopy; D002102:Cadaver; D017885:Collateral Ligaments / Q000033:anatomy & histology*; D004551:Elbow Joint / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D011884:Radius / Q000033:anatomy & histology*; D000074402:Synovectomy
keywords: Anatomy; Elbow joint; LCL; Radial head