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Anterior Oblique Bundle of the MCL



- Discussion:
     - strong and well-defined, arise from antero-inferior surface of medial epicondyle and inserts at the sublimis tubercle, adjacent to the joint 
            surface;
     - primary constraint to valgus instability;
            - in flexion, MCL provides 54% of valgus stability;
            - radial head is most important secondary stabilizer to valgus stress;
     - sub-portions of the anterior oblique bundle:
            - anterior band:
                   - primary restraint to valgus rotation at 30, 60, and 90 deg of flexion and is a co-primary restraint at 120 deg;
                   - this band is more likely to be injured with the elbow in extension;
            - posterior band:
                   - co-primary restraint at 120 deg;
                   - this band is more likely to be injured in flexion (but injury to this band usually occurs along with injury to the anterior band);

- Exam:
    - anterior bundle of the MCL is tested with the elbow in 90 deg of flexion



Biomechanical evaluation of the medial collateral ligament of the elbow.