Some of the muscles that flex the forearm, wrist, and fingers attach to the anterior surface of this marking. This book is distributed under the terms of the creative commons. The medial epicondyle of the femur is a bony protrusion located on the medial side of the bones distal end. Inflammation of the lateral epicondyle of the humeral bone. Inflammation of the lateral epicondyle of the humeral bone enthesopathia epicondyli lateralis humeri is commonly called the tennis elbow. When comparing the medial epicondyle of the humerus to the lateral epicondyle of the humerus, which of the following statements.
Medial epicondyle injection statpearls ncbi bookshelf. Medial epicondyle fractures of the humerus springerlink. Mediallateral epicondylitis is related to repetitive work activities which. Aug 08, 2018 the medial epicondyle creates a prominent, blunt protuberance on the medial side of the condyle and it, is the point where the medial border of the humerus terminates by curving marginally towards the back. It develops where tendons in the forearm muscle connect to the bony part on the inside of the elbow.
It forms a prominent projection from the distal border of the medial supracondylar ridge. Articulation between the distal humerus and proximal forearm is seen on these xrays. Musculotendinous variations about the medial humeral. It is larger and further back on the bone than its counterpart the lateral epicondyle. The medial head is the deepest and takes origin from the lower half of the posterior aspect of the humerus. Isolated fractures can occur secondary to direct trauma or avulsion forces. Medial epicondyle of the humerus an overview sciencedirect. Part of the upper arm bone, or humerus, it occurs at the bottom of the bone where the humerus meets the ulna at the elbow.
A fracture in this projection is called a medial epicondyle fracture of the humerus and is different from a humerus shaft fracture. Nine year old with elbow dislocation and fracture of the medial epicondyle white arrow. On the ap radiograph, the center of the medial epicondyle was compared with a line based upon the inferior olecranon fossa. The medial epicondyle of the femur is a bony protrusion located on the medial side of the bones distal end located above the medial condyle, it bears an elevation, the adductor tubercle, which serves for the attachment of the superficial part, or tendinous insertion, of the adductor magnus. Outcome was assessed with radiographs and a questionnaire that included 3 selfreported functional outcome tools at a mean of 4. The other 3 dogs with radiographic elbow oa at eol had mild 2 dogs and severe 1 dog radiographic oa, respectively table 1. Return to competitive sports after medial epicondyle. Transphyseal fractures are thought to represent the corollary to the elbow dislocation in the very young patient. Specifically, these extensor muscles include the anconeus muscle, the supinator, extensor carpi radialis brevis, extensor. On the lateral radiograph, the average location of the center of the medial epicondyle was 1. Aug 30, 2018 medial epicondylitis me is an overuse injury affecting the flexorpronator muscle origin at the anterior medial epicondyle of the humerus. Palpate the greater tubercle and medial epicondyle of the humerus.
The humerus is the single bone of the upper arm, and the ulna medially and the radius laterally are the paired. Radiograph of the left side demonstrates different areas of distal humeral structures from medial to lateral. Medial epicondyle fractures, transphyseal fractures, and elbow dislocations represent a spectrum of pediatric elbow injuries. Start studying muscle of the arm and handorigins and insertions. The tendons that attach to the medial epicondyle are released and allowed to loosen a bit. These structures include the capitulum and trochlea, the medial and lateral epicondyle, the medial and lateral supracondylar ridges, and the olecranon, radial and coronoid fossae. Due to injury or irritation, they can become swollen and painful.
Medial epicondyle fracture of the humerus emergency. Medial epicondyle is a rounded projection at the distomedial end of the humerus. It is larger and more prominent than the lateral epicondyle and is directed slightly more posteriorly in the anatomical position. It is curved downward and forward, and its pointed end is connected to the medial border, just above the medial. Return to competitive sports after medial epicondyle fractures in adolescent athletes. Humerus medial epicondyle fractures pediatric orthopaedic.
Fracture of the humerus at the medial epicondyle is common in children, and fibrous nonunion occurs in 90% of cases treated conservatively. The medial epicondyle creates a prominent, blunt protuberance on the medial side of the condyle and it, is the point where the medial border of the humerus terminates by curving marginally towards the back. Longterm comparative study of internal fixation with kirschner wires or cannulated screws for displaced medial epicondyle fractures of the humerus. These fractures are four times more common in boys. Davies, christopher philip, in equine podiatry, 2007. Humerus attachments book compression neuropathies orkrelated upper limb disorder claims. Medial epicondyle fractures of the humerus request pdf. The humeral belly has large tendinous intersections and can be further divided into three parts deep, middle, and lateral. The distal humeral shaft widens to constitute the triangular shape of the epiphysis. Lateral epicondyle of humerus attachments book compression neuropathies of the radial nerve living handbooks golfers elbow treatment exercises self treatment for medial. Medial epicondyle fractures of the distal humerus account for 12% of pediatric elbow fractures and are frequently associated with intraarticular incarceration of the fracture fragment, elbow. It serves as the origin of the ulnar collateral ligament, pronator teres, and. There is an avulsion fracture arrow of the medial epicondyle of the right humerus.
Medial epicondyle apophysitis, little leaguers elbow, apophysitis of the medial epicondyle, throwers elbow, pitchers elbow. Fractures of the medial condyle of humerus are uncommon in adults. The flexor muscles which help us flex and pronate turn our palm to the ground our wrist attach to the medial epicondyle. The medial epicondyle is on the distal humerus outside of the elbow joint capsule. Avulsion fracture of the medial and lateral epicondyles of the humerus. Plain radiographs were obtained with the fracture fragment displaced anteriorly in 2mm increments between 0 and 18 mm.
Ap views of both elbows of an 18yearold boy who sustained an injury to the right elbow. The more prominent medial epicondyle is an attachment point for the ulnar collateral. Inflammation of the medial epicondyle of the humerus joints. It is the knob on the inside part of our elbow and serves as an attachment site for various muscles, tendons, and ligaments. Bones play a critical role in providing support and aiding the movement of animals. In birds, where the arm is somewhat rotated compared to other tetrapods, it is called the ventral epicondyle of. Specifically in passive flexion of the elbow, it is subcutaneous and generally noticeable. Medial epicondyle of the humerus wikipedia republished. Medial epicondyle of the humerus wikipedia article audio this is an audio version of a wikipedia article created for the benefit of those who have vision problems or problem reading at night.
Fifty percent of medial epicondyle fractures are associated with an elbow dislocation, which is easily identified on xray. Medial epicondylitis pitchers, golfers elbow, symptoms. Upper arm and elbow knowledge for medical students and. Medial epicondyle fractures of the humerus account for 1220% of pediatric elbow fractures. It is the pain syndrome of soft tissues located in the medial area of the elbow joint, the. Fractures of the medial epicondyle of the distal humerus account for approximately 1220% of all pediatric elbow fractures and occur most frequently between the ages of 9 and 14 beaty, 2005. Most of the upper arm contains the long bone called the humerus.
The medial epicondyle is a secondary growth centre at the elbow, which first appears around age 6 and fuses to the shaft of the humerus at about age 1417 years. The lateral epicondyle of the humerus is a small, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow joint, and to a tendon common to the origin of the supinator and some of the extensor muscles. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The humerus is a long bone of the upper limb, which extends from the shoulder to the elbow. Located above the medial condyle, it bears an elevation, the adductor tubercle, which serves for the attachment of the superficial part, or tendinous insertion, of the adductor magnus. Medial epicondyle fractures represent almost all epicondyle fractures and occur when there is avulsion of the medial epicondyle. Distally, at the elbow joint, the humerus articulates with the head of the radius and trochlear notch of the ulna. In this anatomic descriptive study, we evaluated 171 anteroposterior ap and lateral radiographs from children 4 to 15 years old with a normal distal humerus. Treatment of fractures of the medial epicondyle of the humerus. The prominent bony projection on the medial side is the medial epicondyle of the humerus. Inflammation of the medial epicondyle of the humerus.
The location of the medial humeral epicondyle in children. The medial epicondyle gives attachment to the ulnar collateral ligament of elbow joint, to the pronator teres. Lateral epicondyle of the humerus wikipedia republished. May 10, 2018 if conservative treatment fails, surgery can be done to treat golfers elbow. Prominent bony projection on the lower side medially. Muscles of the humerus and radius ulna flashcards quizlet. Pdf fractures of the medial humeral condyle in adults. How to optimally treat the initial fracture and any subsequent symptomatic nonunion remains controversial. Medial epicondyle of humerus and ulna attachments are on, or near, the medial epicondyle of the humerus. The thickened portion on the inside of the arm is called the medial epicondyle. A number of mechanisms have been implicated in medial epicondylar avulsion fractures 2,4.
Medial epicondyle fracture of the humerus fracture clinics. Medial epicondyle of the humerus wikimili, the free. These injuries can coexist, such as in the case of elbow dislocations and medial epicondyle fractures. A small, hookshaped process of bone, the supracondylar process, varying from 2 to 20 mm. Medial epicondyle fracture with elbow dislocation figure 3. The lateral epicondyle of the humerus is a large, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow joint, and to a tendon common to the origin of the supinator and some of the extensor muscles. There are thickened projections where the humerus joins the elbow. Surgical treatment of displaced medial epicondyle fractures in adolescent athletes. The medial epicondyle is a bony protrusion that can be felt on the inside part of the elbow. Medial epicondyle fracture of the humerus emergency department. Our findings demonstrated a consistent radiographic position of the medial humeral epicondyle with little variation throughout skeletal maturation. Anatomical variations in the musculofascial structures about the region of the medial humeral epicondyle were evaluated in 104 extremities in sixtyfour cadavers. The lower end of the humerus provides the following 7 features.
Oct 18, 2017 main difference condyle vs epicondyle. Operative fixation of medial humeral epicondyle fracture. Methods eight patients with symptomatic medial humeral epicondyle nonunions were evaluated after open reduction and internal fixation of the medial epicondyle. Some of the material presented in these tables is contained in the book. All 3 of these dogs had visible osteophytes on the distal humerus on the craniocaudal projection. The wrist extensors form a strong conjoined tendon which is attached at the lateral. Me is often discussed in conjunction with lateral epicondylitis le, which occurs much more frequently. By definition, the fracture line must involve the trochlear articular surface. One should note that the median nerve and ulnar nerve likewise come off the brachial plexus and travel down along the brachium, however, do not supply innervation to this region. Failure to diagnose these injuries can lead to significant long term disability. Medial epicondylar avulsion fractures are the most common avulsion injury of the elbow and are typically seen in children and adolescents 4. Leg a rounded projection of the distal femur above the medial chondyle. The medial epicondyle is a particularly important landmark, as the ulnar nerve passes around its posterior aspect to enter the forearm it can easily be compressed or damaged at this location. The aims of this study were i to highlight the rarity of this injury, ii to focus on the problems in management of cases.
In 20 patients, the medial intermuscular septum was evaluated histopathologically. Avulsion fracture of the medial and lateral epicondyles of. The medial epicondyle is an important structure in the elbow. This page includes the following topics and synonyms. This muscle arises from the medial epicondyle of the humerus caput humerale, the proximal half of the ulna caput ulnare, and the upper twothirds of the radius caput radiale. Learn more about the anatomy of the humerus in this anatomy tutorial. Selection of our books indexed in the book citation index in web of. Part of the upper arm bone, orhumerus, it occurs at the bottom of the bone where the humerus meets. If conservative treatment fails, surgery can be done to treat golfers elbow. Shoulder disorders, lateralmedial epicondylitis, wrist tendinitis, and car pal tunnel. What is the lateral epicondyle of the humerus answers. Flexor region of the forearm university of arkansas for.
Anatomy, shoulder and upper limb, humerus statpearls. The injured tissue is removed, and if any bone spurs have formed on the medial epicondyle these are. Medial condyle fractures involve a fracture line that extends through and separates the medial metaphysis and epicondyle from the rest of the humerus see image below. What are the potential complications associated with this injury. An osteotomy of a cadaveric humerus was performed to simulate a medial epicondyle fracture. Medial epicondyle fracture radiology reference article. Medial epicondyle, a prominent projection on the medial side. Medial humeral epicondylitis in cats streubel 2012. Medial epicondyle of humerus musculoskeletal, skeletal. All of these areas are attachment points for muscles that act on the forearm, wrist, and hand. Physical medicine and rehabilitation for epicondylitis. Ikimedia commons lateral epicondyle denver apartments.
Lateral epicondyle of the humerus wikimili, the free. Its posterior surface forms a shallow groove for the ulnar nerve this is the nerve, that when bumped, is referred to as hitting the funny bone, while its anterior aspect serves as the muscle attachment site for the superficial flexor muscles of the. In addition, as showed in the scatter diagrams, data from segments that were more than 4 cm distal to the medial epicondyle of humerus were dispersed figure 1 and figure 2 indicating that data of segments that were more than 4 cm distal to the medial epicondyle of humerus were not stable and might be not reliable. In the forelimb, the humeral belly originates from the medial epicondyle of the humerus and lies against the caudal surface of the radius, where it forms the major bulk of the muscle. Articulation between the distal humerus and proximal forearm is seen on. Medial humeral condyle fracture clinical presentation. The biceps brachii is especially unique as it has two distal attachments at the elbow joint. The medial collateral ligament is a triangularshaped ligament made up of.
Arm a rounded projection of the distal humerus and point of attachment of the pronator teres, common tendon of origin for the long palmar, radial flexor of wrist, superficial flexor of finger and ulnar flexor of wrist, and the ulnar collateral ligament. How often should these fractures be followed up in fracture clinics. The medial epicondyle of the humerus is an epicondyle of the humerus bone of the upper arm. The upper arm, or brachium, extends between the shoulder joint and elbow. Management of medial humeral epicondyle fractures in. This disease entity belongs to a group of enthesopathy, or diseases which affect the muscle attachments to the bones so called entheses.
The radial nerve is also responsible for innervation of the lateral and medial epicondyle of the humerus. A medial epicondyle fracture is an avulsion injury of the attachment of the common flexors of the forearm. The tendons are split to reveal the area of angiofibroblastic tendinosis. The medial epicondyle is more prominent than the lateral epicondyle. The medial epicondyle of the humerus is an epicondyle of the humerus bone of the upper arm in humans. This region articulates with the trochlear notch of the ulna bone at the elbow joint.
Intraarticular entrapment of the fracture fragment in the. Anteroposterior ap, internal oblique ir, lateral lat, and distal humerus axial axial views were performed. Essentials of physical medicine and rehabilitation ebook. The proximal aspect of the humerus articulates with the glenoid fossa of the scapula, forming the glenohumeral joint. Medial epicondyle definition of medial epicondyle by. Anatomy, shoulder and upper limb, elbow joint statpearls ncbi. Among the different types of bone in the body, long bones such as femur, tibia, ulna, and humerus are especially involved in the movement of. The skin is retracted and the subcutaneous fat is elevated sufficiently to allow visualization of the brachial and collateral ulnar vessels. Medial epicondyle avulsion fractures elbow conditions. Start studying muscles of the humerus and radius ulna. They are typically seen in children, and can be challenging to identify. Surgical excision of the medial epicondylar fragment should be avoided because the longterm results are poor. Mar 20, 2020 medial condyle fractures involve a fracture line that extends through and separates the medial metaphysis and epicondyle from the rest of the humerus see image below. In birds, where the arm is somewhat rotated compared to other tetrapods, it is called the ventral epicondyle of the humerus.
Among the different types of bone in the body, long bones such as femur, tibia, ulna, and humerus are especially involved in the movement of the body. Inflammation of the medial epicondyle of the humerus enthesopathia epicondyli medialis humeri is also called the golfers elbow or, less frequently, the javelins elbow, or climbers elbow. Medial epicondylitis golfers elbow is a type of tendinitis that affects the inside of the elbow. Medial epicondyle fractures, elbow dislocations, and. Medial humerus epicondyle fracture is the most common associated injury in complex paediatric elbow dislocation1. On what bone can you find the medial epicondyle answers. Intraarticular entrapment of medial epicondyle fracture. Trochlea is a pulleyshaped formation located medial to the capitulum. The purpose of this study was identification of the innervation of the medial humeral epicondyle which has not been described before. Difference between condyle and epicondyle definition. Epicondyle medical definition merriamwebster medical. When should i refer for an orthopaedic consultant opinion. The skin incision extends from the medial epicondyle proximally along the cranial border of the humerus to the midshaft of the bone. Four tendons arise, which are inserted into the palmar sides of the terminal phalanges of digits i to iv.
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