title: Three-dimensional analysis of elbow soft tissue footprints and anatomy.
abstract: BACKGROUND
  Tendinous and ligamentous injuries commonly occur in the elbow. This study characterized the location, surface areas, and origin and insertional footprints of major elbow capsuloligamentous and tendinous structures in relation to bony landmarks with the use of a precision 3-dimensional modeling system.
  
  
  METHODS
  Nine unpaired cadaveric elbow specimens were dissected and mounted on a custom jig. Mapping of the medial collateral ligament (MCL), lateral ulnar collateral ligament (LUCL), triceps, biceps, brachialis, and capsular reflections was then performed with 3-dimensional digitizing technology. The location, surface areas, and footprints of the soft tissues were calculated.
  
  
  RESULTS
  The MCL had a mean origin (humeral) footprint of 216 mm(2), insertional footprint of 154 mm(2), and surface area of 421 mm(2). The LUCL had a mean origin footprint of 136 mm(2), an insertional footprint of 142 mm(2), and a surface area of 532 mm(2). Of the tendons, the triceps maintained the largest insertional footprint, followed by the brachialis and the biceps (P < .001-.03). The MCL, LUCL, and biceps footprint locations were consistent, with little variability. The surface areas of the anterior (1251 mm(2)) and posterior (1147 mm(2)) capsular reflections were similar (P = .82), and the anterior capsule extended farther proximally.
  
  
  CONCLUSIONS
  Restoring the normal anatomy of key elbow capsuloligamentous and tendinous structures is crucial for effective reconstruction after bony or soft tissue trauma. This study provides the upper extremity surgeon with information that may aid in restoring elbow biomechanics and preserving range of motion in these patients.
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Capo
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey-Rutgers, Newark, NJ, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Collins
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA. Electronic address: bryanbeutel@gmail.com.
authors.forename: Bryan G
authors.initials: BG
authors.lastname: Beutel
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
authors.forename: Natalie R
authors.initials: NR
authors.lastname: Danna
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
authors.forename: Michaele
authors.initials: M
authors.lastname: Manigrasso
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey-Rutgers, Newark, NJ, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Uko
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey-Rutgers, Newark, NJ, USA.
authors.forename: Linda Y
authors.initials: LY
authors.lastname: Chen
mesh_terms: D000368:Aged; D002102:Cadaver; D004210:Dissection; D004550:Elbow / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology; D007091:Image Processing, Computer-Assisted; D017746:Joint Capsule / Q000033:anatomy & histology; D008023:Ligaments, Articular / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011884:Radius / Q000033:anatomy & histology; D013710:Tendons / Q000033:anatomy & histology; D014457:Ulna / Q000033:anatomy & histology
keywords: Elbow; anatomy; footprint; ligament; surface area; tendon; three-dimensional