The oblique cord is a flat, inconstant ligamentous band running from the lateral side of the ulnar tuberosity obliquely downward and laterally to the radius just below the radial tuberosity. Unlike the interosseous membrane, its fibres run in the opposite direction, resisting distal-to-proximal radial migration. It is present in approximately 85% of individuals.
Resists proximal migration of the radius, particularly after radial head excision, and stiffens the proximal forearm during pronation-supination.
The oblique cord becomes clinically important after radial head excision, where it is one of the few remaining restraints to proximal radial migration (Essex-Lopresti lesion). Its absence in some individuals may increase proximal radial migration risk. The cord is visualised on ultrasound as a hyperechoic band just distal to the bicipital tuberosity. In forearm interosseous membrane reconstruction, the oblique cord is preserved to supplement the central band reconstruction.
Combined radial head fracture and interosseous membrane disruption allowing proximal radial migration, where the oblique cord provides the only remaining proximal restraint and must be preserved during radial head excision.
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