The anterior oblique band is a distinct fascicular thickening within the medial elbow capsule, running obliquely from the medial epicondyle to the coronoid process. It is the primary stabiliser against valgus stress in the range of 30-120 degrees of elbow flexion.
Primary restraint to valgus elbow stress from 30-120 degrees; the most clinically significant component of the ulnar collateral ligament complex.
The anterior oblique band is the structure reconstructed in UCL reconstruction (Tommy John surgery) for overhead throwing athletes. Its integrity is assessed by valgus stress testing at 30 degrees flexion and the milking manoeuvre. MRI arthrography demonstrates the band at its coronoid insertion, the most common tear site. Repair is preferred for acute tears, reconstruction for chronic insufficiency.
Repetitive or acute failure of the medial elbow anterior oblique band from valgus loading in overhead throwing, producing medial elbow pain and instability, managed by UCL reconstruction in athletes requiring return to overhead sport.
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