Varus stresses of the elbow are best stabilized in which position?

• A. Elbow extension
• B. Elbow flexion and supination
• C. Elbow flexion and pronation
• D. Neutral with rotation

Answer: (C)

Varus stability at the elbow mainly comes from the lateral collateral ligament complex, which tightens as the elbow moves into flexion and the forearm rotates into pronation. In this position, the radial and ulnar collateral ligaments are placed under maximal tension, providing the greatest restraint against varus forces. When the elbow is extended, or when the forearm is in supination (or neutral), those ligaments are relatively less taut, so the joint is less resistant to varus stress. Therefore, flexion with pronation best stabilizes the elbow against varus stresses.