The quadrate ligament (ligament of Denuce) is a short rectangular band running between the inferior border of the radial notch of the ulna and the medial surface of the radial neck, reinforcing the inferior capsule of the proximal radioulnar joint. It limits excessive supination and pronation at the proximal radioulnar joint.
Reinforces the inferior proximal radioulnar joint capsule and limits excessive rotation at the radial neck.
The quadrate ligament is disrupted in Monteggia fracture-dislocations and radial head dislocations requiring open reduction. Its repair or reconstruction restores inferior proximal radioulnar joint stability after dislocation. The ligament is also the primary restraint to radial head distraction and is assessed during elbow arthroscopy for proximal radioulnar joint instability. Its anatomy is relevant in radial head arthroplasty sizing to avoid impingement.
Disruption of the quadrate ligament in Monteggia injuries or radial head dislocation producing longitudinal rotational instability at the proximal radioulnar joint, requiring ligament repair as part of complex elbow reconstruction.
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