Arterial Anastomosis Around the Elbow Joint
The arterial anastomosis around the elbow joint links the brachial artery (via its collateral branches) with the upper ends of the radial and ulnar arteries (via their recurrent branches). It ensures continued blood supply to the forearm if the brachial artery is occluded at the elbow, and supplies the ligaments and bones of the elbow joint.
For easy recall, the anastomosis is divided into five parts based on location around the epicondyles:
1. In Front of the Medial Epicondyle
- Inferior ulnar collateral artery and a branch from the superior ulnar collateral artery (both branches of the brachial artery)
- anastomose with
- Anterior ulnar recurrent artery (branch of the ulnar artery)
2. Behind the Medial Epicondyle
- Superior ulnar collateral artery and a branch from the inferior ulnar collateral artery (both branches of the brachial artery)
- anastomose with
- Posterior ulnar recurrent artery (branch of the ulnar artery)
3. In Front of the Lateral Epicondyle
- Radial collateral artery (anterior descending branch of the profunda brachii artery)
- anastomoses with
- Radial recurrent artery (branch of the radial artery)
4. Behind the Lateral Epicondyle
- Posterior descending branch of the profunda brachii artery
- anastomoses with
- Interosseous recurrent artery (branch of the posterior interosseous artery), and a branch of the common interosseous artery (branch of the ulnar artery)
5. Above the Olecranon Fossa
- Middle collateral artery (branch of the profunda brachii artery)
- anastomoses with
- A transverse branch from the posterior division of the inferior ulnar collateral artery
Summary Table
| Location | Brachial-derived Contribution | Anastomoses With |
|---|---|---|
| In front of medial epicondyle | Inferior ulnar collateral + branch of superior ulnar collateral | Anterior ulnar recurrent (from ulnar artery) |
| Behind medial epicondyle | Superior ulnar collateral + branch of inferior ulnar collateral | Posterior ulnar recurrent (from ulnar artery) |
| In front of lateral epicondyle | Radial collateral (from profunda brachii) | Radial recurrent (from radial artery) |
| Behind lateral epicondyle | Posterior descending branch (from profunda brachii) | Interosseous recurrent + common interosseous artery branch (from ulnar artery) |
| Above olecranon fossa | Middle collateral (from profunda brachii) | Transverse branch of inferior ulnar collateral (posterior division) |
Functional Significance
- Maintains forearm perfusion in cases of brachial artery occlusion proximal to the elbow.
- Clinically relevant in supracondylar fractures of the humerus, where displacement may compromise the brachial artery while the collateral circulation partially compensates distally.