Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 20;7(3):100712.
doi: 10.1016/j.jhsg.2025.02.005. eCollection 2025 May.

The Medial Collateral Artery is Not Medial

Casey N Urban  1 , Daniel A Osei  1 , Scott W Wolfe  1
Affiliations

The Medial Collateral Artery is Not Medial

Casey N Urban et al. J Hand Surg Glob Online. .

Abstract

Purpose: Current literature interchangeably uses the terms "middle" and "medial" for the middle collateral artery (MCA). However, the term "medial" implies that the artery is positioned on the medial aspect of the arm, which may lead to misunderstandings in medical education or interdisciplinary communication. Our purpose is to provide anatomic and historical support for the use of the original "middle collateral artery" terminology.

Methods: We reviewed a 300-year history of anatomy texts to elucidate the origin of the MCA nomenclature. In three cadaveric specimens, the MCA was dissected following latex infusion and its vascular contribution to three pedicled flaps was demonstrated. In three additional specimens, the arms were imaged with computed tomography and three-dimensional reconstruction following barium sulfate infusion.

Results: The term "middle" collateral artery predates the term "medial" collateral artery by 80 years. The origin of the term "medial" collateral artery is likely a mistranslation of the predecessor Latin term, "arteria collateralis media." Our cadaveric dissections and computed tomography imaging confirmed that the MCA's course is on the posterolateral side of the arm between the anterolateral-positioned radial collateral artery and the medial-positioned superior ulnar collateral artery.

Conclusion: The term "medial" collateral artery is an anatomic misnomer. "Middle" collateral artery, its original name, accurately reflects its posterolateral position in the arm between the radial collateral artery and superior ulnar collateral artery. We recommend that authors use the term "middle" collateral artery based on its anatomical position and recommend discontinuation of the term "medial" collateral artery in the scientific literature.

Clinical relevance: Given the MCA's surgical significance in reconstructive flaps, nonanatomic labeling of the MCA as "medial" may lead to misunderstandings in medical education and surgical site identification. Replacing a misnomer with an anatomically accurate name would improve professional communication and teaching.

Keywords: Computed tomography; Medial collateral artery; Middle collateral artery; Pedicle flap; Profunda brachii.

PubMed Disclaimer

Conflict of interest statement

No benefits in any form have been received or will be received related directly to this article.

Figures

Figure 1
Figure 1
A–C Three-dimensional renderings of three right upper-extremity CT scans with contrast that illustrate the vascular anatomy of the posterolateral arm. Postprocessing coloring was used to highlight MCA, RCA, and profunda brachii in yellow, red, and blue, respectively.
Figure 2
Figure 2
Dissection of the MCA and its neighboring structures in a right upper extremity with a demonstration of the anconeus reconstructive flap using the MCA as the blood supply.
Figure 3
Figure 3
A Dissection of the MCA and its neighboring structures in a left upper extremity (flipped image). B This is followed by a corresponding demonstration of the medial triceps reconstructive flap over the olecranon. The MCA provides pedicled blood supply for the flap.
Figure 4
Figure 4
A Dissection of the MCA and its neighboring structures in a right upper extremity. B This is followed by rotation of the “extreme” lateral arm reconstructive flap to the posterolateral forearm. Blood flows retrograde through the MCA from its anastomosis at the anconeus and flows anterograde through the RCA to supply the skin flap.
See this image and copyright information in PMC

References

    1. Doyle J.R. Lippincott Williams & Wilkins; 2003. Surgical Anatomy of the Hand and Upper Extremity; pp. 245–246.
    1. Delgove A., Weigert R., Casoli V. Evaluation of donor site morbidity after medial triceps brachii free flap for lower limb reconstruction. Arch Orthop Trauma Surg. 2017;137:1659–1666. - PubMed
    1. Delgove A., Weigert R., Casoli V. A new local muscle flap for elbow coverage-the medial triceps brachii flap: anatomy, surgical technique, and preliminary outcomes. J Shoulder Elbow Surg. 2018;27:733–738. - PubMed
    1. Elhassan B., Karabekmez F., Hsu C.C., Steinmann S., Moran S. Outcome of local anconeus flap transfer to cover soft tissue defects over the posterior aspect of the elbow. J Shoulder Elbow Surg. 2011;20:807–812. - PubMed
    1. Luchetti R., Atzei A., Brunelli F., Fairplay T. Anconeus muscle transposition for chronic lateral epicondylitis, recurrences, and complications. Tech Hand Up Extrem Surg. 2005;9:105–112. - PubMed