The anterior elbow capsule is a thin fibrous structure spanning from the anterior distal humerus (above the coronoid and radial fossae) to the anterior coronoid process and annular ligament, forming the anterior wall of the elbow joint. It is reinforced by oblique fibres anteriorly and merges with the medial and lateral collateral ligaments at its edges.
| Origin | Anterior distal humerus above the coronoid and radial fossae |
|---|---|
| Insertion | Anterior margin of the coronoid process and the annular ligament |
Provides anterior containment of the elbow joint and limits hyperextension; becomes taut in full extension.
The anterior elbow capsule contracts in post-traumatic elbow stiffness and heterotopic ossification, producing a flexion contracture (loss of extension). Anterior capsulotomy or capsulectomy is the main procedure to regain extension. The brachialis muscle lies immediately anterior and must be carefully elevated, and the median nerve, brachial artery and radial nerve are at risk during aggressive anterior release. The capsule attaches a little below the tip of the coronoid and is torn in elbow dislocations, including the terrible triad (dislocation with radial head and coronoid fractures).
Fibrotic thickening of the anterior capsule after elbow fracture or prolonged immobilisation producing a fixed flexion contracture with loss of extension, treated by progressive splinting or surgical anterior capsulotomy.
Elbow dislocation with radial head and coronoid fractures and capsular disruption, needing fixation or replacement of the bony injuries and lateral ligament repair to restore stability.
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