Common Medial Epicondylitis

Chronic stress injury of the medial epicondyle can cause degeneration of the common flexor tendon and enlargement, sclerosis, fragmentation and phy-seal widening around the medial epicondyle. It is often found in children involved in throwing sports due to repeated valgus stress around the elbow. It is often called little leaguers elbow . 

Epicondylitis is a common elbow problem, generally called tennis elbow if the lateral epicondyle is involved and golfer s elbow if the medial epicondyle is involved. This is an overuse syndrome that is associated with any activity that requires repetitive pronation and supination, such as gripping a tennis racquet, golf club, screwdriver, or doorknob. The wrist extensor muscles are involved in lateral epicondylitis. 

The medial collateral ligamentous complex, also known as the ulnar collateral ligament, is composed of three bands in continuity with each other anterior, posterior and oblique (Fig. 8.3a). The anterior band is the most conspicuous and extends from the medial epicondyle to the medial aspect of the coronoid process, providing the major constraint to valgus stress. The posterior band arises from the posterior aspect of the medial epicondyle and inserts into the medial edge of the olecranon. The oblique band, commonly referred to as the ligament of Cooper , is the weakest and bridges the insertions of the anterior and posterior bands on the ulna. 

The medial compartment includes the pronator teres and the superficial flexor muscles of the wrist and hand that arise from the medial epicondyle as the common flexor tendon . The pronator teres is the most superficial and anterior of the medial muscles. It has two proximal attachments one (humeral head) immediately proximal to the medial epicondyle and the common flexor tendon, the other (ulnar... 

Fig. 8.62a-f. Dynamic study of the cubital tunnel in ulnar nerve dislocation. a-c Schematic drawings and d-f respective series of transverse 12-5 MHz US images obtained a,d with extended elbow and during progressive degrees of elbow flexion (b,e and c,f). When the elbow is extended, the ulnar nerve (arrow) is contained within the tunnel. Elbow flexion gradually pushes the nerve over the medial epicondyle (ME) until it snaps completely out of the cubital tunnel to lie superficial to the common flexor tendon origin (ft). 0, olecranon... 

The superficial layer of volar muscles consists of the flexor digitorum superficialis, the pronator teres, the palmaris longus, the flexor carpi radialis and the flexor carpi ulnaris (Fig. 9.2b,c). These muscles take their origin from a strong common tendon which arises from the medial epicondyle (see Chapter 8). The flexor digitorum superficialis, the largest muscle of the superficial layer, consists of three heads - humeral, ulnar and radial - which join at the proximal forearm and continue distally in four distal tendons that insert into the middle phalanx of the... 

Common tendon from medial epicondyle of humerus. 

Common tendon from medial epicondyle of humems, medial margin of olecranon, coronoid process, and upper two-thirds of the dorsal border of ulna. 

Common tendon from medial epicondyle of humerus, coronoid process of ulna and oblique line of radius. 

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