Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
J Anat. 2024 Jan;244(1):96-106. doi: 10.1111/joa.13943. Epub 2023 Aug 11.
Although the term articularis cubiti muscle is incorporated in the official anatomical nomenclature, only sparse data about its appearance are available. It is usually described as few fibres originating from the medial head of the triceps brachii muscle and inserting to the capsule of the elbow joint. However, the most recent observations regarding the morphological relations in the posterior elbow region point towards the absence of a well-defined muscle. Therefore, this study was designed to verify the existence of the articularis cubiti muscle in question and to compile more data on the topographical features of the subtricipital area near the posterior aspect of the elbow. To address these questions, 20 embalmed upper limbs were dissected, and seven samples were collected for histological analysis. The laboratory findings were then correlated with 20 magnetic resonance imaging (MRI) scans of the elbow. Consequently, a narrative review of literature was performed to gain more information on the discussed muscle in a historical context. Upon the anatomical dissection, muscular fibres running from the posterior aspect of the shaft of the humerus to the elbow joint capsule and olecranon were identified in 100% of cases. Histologically, the connection with the joint capsule was provided via winding bands of connective tissue. On MRIs, the muscular fibres resembled a well-demarcated thin muscle located underneath the medial head of the triceps brachii muscle. Combined with the review of literature, we concluded that the constant articularis cubiti muscle originates from the posterior shaft of the humerus and attaches indirectly to the posterior aspect of the elbow joint capsule and directly to the superior portion of the olecranon. The obtained results slightly differ from the modern description, but are in agreement with the original publication, which has become misinterpreted throughout time. Presumably, the misused description has led to questioning the existence of an independent muscle. Moreover, our findings attribute to the articularis cubiti muscle, a function in pulling on the posterior aspect of the elbow joint capsule to prevent its entrapment, and possibly also a minor role in extension of the forearm. The presented results should be taken into consideration when intervening with the posterior aspect of the elbow joint because the articularis cubiti muscle poses a consistently appearing landmark.
虽然术语“肘突肌”包含在官方解剖学命名法中,但关于其外观的资料却很少。它通常被描述为起源于肱三头肌内侧头的少数纤维,并插入肘关节囊。然而,最近对肘部后区形态关系的观察表明,并不存在一个明确界定的肌肉。因此,本研究旨在验证所讨论的肘突肌的存在,并对肘部后区附近的肱二头肌下区域的局部解剖特征收集更多数据。为了解决这些问题,我们对 20 例防腐上肢进行了解剖,并采集了 7 个样本进行组织学分析。然后将实验室结果与 20 例肘部磁共振成像(MRI)扫描进行了相关性分析。随后,我们进行了文献综述,以在历史背景下获得更多关于所讨论肌肉的信息。在解剖过程中,我们在 100%的病例中发现了从肱骨后段延伸至肘关节囊和尺骨鹰嘴的肌纤维。组织学上,这些肌纤维通过结缔组织的缠绕带与关节囊相连。在 MRI 上,这些肌纤维类似于位于肱三头肌内侧头下方的界限分明的薄肌。结合文献综述,我们得出结论,恒定的肘突肌起源于肱骨后段,并通过间接附着于肘关节囊的后段,直接附着于尺骨鹰嘴的上部。这些结果与现代描述略有不同,但与原始出版物一致,原始出版物随着时间的推移被误解。据推测,这种误用的描述导致人们对独立肌肉的存在产生了质疑。此外,我们的发现表明,肘突肌具有拉动肘关节囊后段的功能,以防止其被卡压,并且可能在前臂伸展中也具有较小的作用。当对肘关节后区进行干预时,应考虑到这些结果,因为肘突肌是一个始终存在的标志。