Hinge Joint – Anatomy, Nerve and Blood Supply

A hinge joint is a type of synovial joint that exists in the body and serves to allow motion primarily in one plane. The hinge joint is made up of two or more bones with articular surfaces that are covered by hyaline cartilage? and lubricated by synovial fluid.[rx] Stabilization of each hinge joint is by muscles, ligaments, and other connective tissues, such as the joint capsule.[rx][rx] The hinge joints of the body include the elbow, knee, interphalangeal (IP) joints of the hand and foot and the tibiotalar joint of the ankle.

A hinge joint (ginglymus) is a bone joint in which the articular surfaces are molded to each other in such a manner as to permit motion only in one plane. According to one classification system, they are said to be uniaxial (having one degree of freedom).^[rx] The direction which the distal bone takes in this motion is seldom in the same plane as that of the axis of the proximal bone; there is usually a certain amount of deviation from the straight line during flexion.

Structure and Function

Hinge joints function by allowing flexion and extension in one plane with small degrees of motion in other planes.[rx] The hinge joint is an essential component of the complex biomechanics of the human body.[rx] The knee, elbow, and ankle can support large amounts of force and aid in the performance of work. Interphalangeal joints are smaller and contribute primarily to dexterity.[rx] A hinge joint is more stable than a ball and socket joint but offers less mobility.

Blood Supply

• Elbow  – The structures of the elbow receive much of their blood supply from branches of the brachial, radial, and ulnar arteries that form a series of anastomosis around the joint. Most of the elbow lymphatics follow the vasculature and flow to the axillary, clavicular, and cervical? lymph nodes. Some of the lymphatics from the forearm and hand flow through the cubital nodes.[rx][rx][rx]
• Knee – The structures of the knee receive much of their blood supply from a plexus of arteries with branches from the popliteal artery and femoral artery. The genicular arteries and tibial recurrent arteries are the main contributing branches. Much of the lymphatic drainage from the knee follows vasculature and travels to the popliteal and inguinal lymph nodes.[rx][rx]
• IP Hand – The IP joints of the hand receive blood supply from branches of the radial and ulnar arteries. The major contributing branches are the superficial and deep palmar arches. Lymphatics travel superiorly along the upper extremity to the cubital, axillary, cervical?, and clavicular lymph nodes.[rx][rx]
• IP Foot – The IP joints of the foot receive blood supply from branches of the anterior and posterior tibial arteries. The major contributing branches are the dorsal and plantar metatarsal arteries. Lymphatics flow superiorly up the lower limb through the popliteal and inguinal lymph nodes.[rx][rx]
• Ankle – The structures of the ankle receive much of their blood supply from anastomosis between branches of the anterior and posterior tibial and fibular arteries. Lymphatics flow superiorly up the lower limb through the popliteal and inguinal lymph nodes.[rx][rx]

Nerves

• Elbow – The components of the elbow receive innervation from branches of the median, radial, ulnar, and musculocutaneous nerves.[rx][rx][rx]
• Knee – The components of the knee receive innervation from branches of the femoral nerve (L1, L2, L3) and the sciatic nerve (L4, L5, S1, S2, S3), which branches into the tibial nerve and common peroneal nerve.[rx]
• IP – The IP joints of the hand receive innervation from branches of the radial, median, and ulnar nerves. The IP joints of the foot receive innervation from branches of the tibial, sural, and fibular nerves.[rx][rx][rx]
• Ankle – The components of the ankle receive innervation from branches of the tibial, sural, fibular, and saphenous nerves.[rx]

Muscles

• Elbow – Flexion is primarily the function of the brachialis, biceps brachii, and brachioradialis muscles, which originate on various locations of the humerus and scapula and insert on portions of the radius and ulna. Extension is primarily accomplished by the triceps brachii and anconeus muscles, which originate from various locations on the humerus and scapula and insert on portions of the ulna.[rx][rx]
• Knee – Flexion is made possible, primarily, by the articularis genus, rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis. These muscles originate from various locations on the femur and anterior inferior iliac spine. The vastus lateralis, vastus intermedius, and vastus medialis conjoin to form the patellar tendon?, which crosses the knee anteriorly and inserts on the patella and tibial tuberosity. Extension is predominately the function of the biceps femoris, semitendinosus, semimembranosus, gastrocnemius, plantaris, gracilis, and popliteus.[rx][rx] These muscles originate from the ischial tuberosity, inferior pubic ramus, and different locations on the femur. They insert on various locations of the tibia, fibula, and calcaneus.[rx]
• IP hand – Flexion of the hand IP joints primarily occurs through the functions of the flexor digitorum profundus, flexor pollicis longus, and flexor digitorum superficialis. They originate from various locations of the radius, ulna, interosseous membrane, and medial epicondyle, and insert on portions of the phalanges. Extension of the hand IP joints is provided by the extensor pollicis longus, extensor pollicis brevis, extensor digitorum, extensor indicis, and extensor digiti minimi. They originate from various locations of the radius, ulna, interosseous membrane, and lateral epicondyle, and insert on portions of the phalanges.[rx][rx]
• IP foot – Flexion of the foot IP joints result from the action of the flexor digitorum longus and brevis, flexor hallucis longus and brevis, quadratus plantae, and flexor digiti minimi brevis. They originate from various locations of the tibia, fibula, and calcaneus, and insert on portions of the phalanges. Extension of the foot IP joints is primarily the function of the extensor digitorum longus and brevis, lumbricals, and extensor hallucis longus muscles, which originate on the tibia, calcaneus, flexor tendons, and fibula, and insert on portions of the phalanges.[rx][rx]
• Ankle – Plantarflexion and inversion result from the actions of the gastrocnemius, plantaris, soleus, tibialis posterior, and anterior. They originate from various locations of the femur, tibia, and fibula, and insert on portions of the calcaneus, navicular, medial cuneiform, and metatarsal bones. Dorsiflexion and eversion occur as functions of the tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus brevis, and longus. They originate from various locations on the tibia and fibula and insert on portions of the phalanges, metatarsals, and medial cuneiform bones.[rx][rx]