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# Elbow artery network

The elbow artery network is a ring of linked small arteries around the elbow; it keeps blood flowing to the forearm when the elbow is bent.

Official name: Collateral and recurrent arteries around the elbow

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## What it is

Small arteries that link above and below the elbow.

## What it does

Keep blood flowing to the forearm when the elbow is bent.

## Key points

- Four links: superior ulnar collateral–posterior ulnar recurrent, inferior ulnar collateral–anterior ulnar recurrent, radial collateral–radial recurrent, middle collateral–recurrent interosseous
- Because of this network, ligation of the brachial artery below the origin of the deep brachial artery is usually tolerated
- The superior ulnar collateral artery travels with the [ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/) behind the medial epicondyle; the radial collateral artery travels with the [radial nerve](https://durgical.com/en/anatomy/radial-nerve/) in front of the lateral epicondyle

## Key facts

**Origin**
Brachial, deep brachial, radial, ulnar and [interosseous arteries](https://durgical.com/en/anatomy/interosseous-arteries-of-the-forearm/)

**Branches**
Superior/inferior ulnar collateral, middle/radial collateral, radial/ulnar/interosseous recurrent

**Supplies**
Anastomosis around the elbow (collateral flow when bent or injured)

## Relations

**Medial**
Superior and inferior ulnar collateral arteries from the [brachial artery](https://durgical.com/en/anatomy/brachial-artery/) meet the posterior and anterior ulnar recurrent arteries from the [ulnar artery](https://durgical.com/en/anatomy/ulnar-artery/), behind and in front of the medial epicondyle

**Lateral**
The radial collateral artery (from the [deep brachial artery](https://durgical.com/en/anatomy/deep-brachial-artery/)) meets the radial recurrent artery between [brachioradialis](https://durgical.com/en/anatomy/brachioradialis/) and [brachialis](https://durgical.com/en/anatomy/brachialis/)

**Behind**
The middle collateral artery meets the recurrent interosseous artery behind the lateral epicondyle, near the [anconeus](https://durgical.com/en/anatomy/anconeus/)

## How to find it

Not palpable. After a brachial artery block, angiography shows these channels enlarged as a collateral bed; in surgery they are met around the epicondyles.

## On imaging

Seen on their own only on angiography, where they form the network around the elbow that joins the collateral branches of the brachial and deep brachial arteries to the recurrent branches of the radial, ulnar and interosseous arteries. After brachial artery injury above the elbow, angiography may show the forearm filling through this network, which is why the hand can stay warm without a pulse.

## Clinical notes

- After a supracondylar fracture with brachial artery injury, collateral flow can keep the hand warm and pink without a radial pulse (the "pink pulseless hand"), which can hide arterial damage
- Ulnar nerve transposition at the elbow: the superior ulnar collateral artery runs with the nerve and is often moved with it
- Elbow dislocation and surgery around the epicondyles can break several links at once and reduce collateral protection

## Memory aid

On the ulnar side: "superior with posterior, inferior with anterior".

## Test yourself

Think of the answer, then tap the question to see it.

## Which vessels pair up on the ulnar side of the elbow artery network?

Superior ulnar collateral with posterior ulnar recurrent, and inferior ulnar collateral with anterior ulnar recurrent.

## What is the «pink pulseless hand» after a supracondylar fracture?

Collateral flow through the elbow artery network keeps the hand warm and pink without a radial pulse, which can hide brachial artery damage.

## Which artery of the elbow network travels with the ulnar nerve behind the medial epicondyle?

The superior ulnar collateral artery; it is often moved with the nerve in ulnar nerve transposition.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
arteria recurrens ulnaris TA2 4656

**Official Spanish (DeCS)**
Arterias recurrente ulnar, colaterales radial, media y ulnares superior e inferior

**English (TA2)**
Collateral and recurrent arteries around the elbow

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Profunda Brachii Artery](https://www.ncbi.nlm.nih.gov/books/NBK542225/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/collateral-and-recurrent-arteries-around-the-elbow/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/collateral-and-recurrent-arteries-around-the-elbow/